La Fondation Rose et Verte de Louisiane in partnership with ALPHA KAPPA ALPHA SORORITY, INCORPORATED PHI SIGMA OMEGA CHAPTER
P.O. BOX 403 GONZALES, LA 70707
2026 Scholarship Application Form
Read and follow the instructions carefully prior to submitting your application. Winners will be notified by email.
PART 1. PERSONAL
Candidate's Name
*
First Name
Last Name
Mailing Address
*
Street Address
Apt/Unit #
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Cellular Phone
*
Format: (000) 000-0000.
Home Phone Number
Format: (000) 000-0000.
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Parent’s Full Name
*
PART 2. EDUCATIONAL BACKGROUND
(NOTE: A seven-semester transcript, available test scores, and a letter of reference must accompany this application.
High School
*
School Address
*
Street Address
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
School Phone
Format: (000) 000-0000.
Current Cumulative GPA
*
ACT/SAT Composite Score:
*
Upload seven-semester transcript
*
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Upload letter of reference
*
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Upload available test scores
*
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PART 3. ACTIVITIES/COMMUNITY SERVICE
1. List the school organization(s) in which you are a member and any offices held. (maximum 600 words).
*
0/600
2. List your community involvement/volunteer activities and the number of hours per month you volunteered. (maximum 600 words). Please upload copies of volunteer certificates if applicable, sponsors may be contacted.
*
0/600
Upload volunteer certificate
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of
PART 4. ADDITIONAL INFORMATION
1. What college/university do you plan to attend?
*
2. What is your anticipated major field of study?
*
PART 5. 15 MINUTE CANDIDATE ZOOM INTERVIEW (To be scheduled after the completion of the application)
By checking the box below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Please verify that you are human
*
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