JOHN JACOB DOLD SCHOLARSHIP Application Form

Full Application Form Accepted in American Sign Language or in Written English.
JOHN JACOB DOLD SCHOLARSHIP

The DOLD SCHOLARSHIP provides funding for eligible Deaf High School graduates in the state of Kansas regardless of their gender. Recipients have up to four (4) years after graduation to enroll in and use the scholarship at any post secondary educational institution of their choice.

PURPOSE

The John Jacob Dold Scholarship is funded by Kansas Association of the Deaf (KAD). The KAD Board developed this scholarship to help High School graduates in the state of Kansas to apply for post secondary educational institutions. This applies to any Deaf and Hard of hearing graduates from any type of schools such as public or mainstream in the state of Kansas. The fund is available as long as it lasts.

HISTORY

John Jacob Dold was the first President of Kansas Association of the Deaf (KAD) in 1909-1911. He was called “JJ Dold” and a long time member of KAD. He was born in Muscatine, Iowa; and attended Iowa School for the Deaf. He moved to Olathe, Kansas. He was an educator and a teacher at Kansas School for the Deaf for 46 years from 1893 to 1942 before retiring. One year later he passed away at the age of 78.

AWARD AMOUNT: $2,000 per high school senior, up to two seniors annually

ELIGIBILITY CRITERIA
- Applicant(s) must be Deaf (include people who may identify as Deaf, DeafBlind, Deaf+, Hard of Hearing, or Late-Deafened). Must submit an audiogram signed by a licensed audiologist, otolaryngologist, physician, or certified technician.
- Applicant(s) must be a senior in any type of high school. This scholarship is not open to the students of Kansas School for the Deaf as they have the opportunity with the LaRosh Scholarship.
- Applicant(s) must be a Kansas Resident. KAD will use the applicant's State Issued ID or Driver's License as proof.
- Applicant(s) must demonstrate strong academic performance and achieve success in their coursework. A letter of recommendation is highly encouraged.
- Applicant(s) must submit GPA of 2.5 or above and/or ACT scores with a minimum of 14.
APPLICATION PERIOD: Applications are due by April 1st of the year.
APPLICANT INFORMATION
Name of Applicant*
Applicant's Date of Birth*

MonthDayYear
Text Number*
Please enter a valid phone number
Video Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Applicant's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant's Proof of Date of Birth and Address:*

Please upload an image of your Drivers License or qualifying state ID.
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Current School:*
GPA/Academic Standing:*
Major/Field of Study:*
Expected Graduation Date:*
Achievements (list academic honors, awards, or recognitions):*
If in ASL, please provide a link to the ASL version
Extracurricular activities (list extracurricular activities, leadership roles or volunteer work):*
If in ASL, please provide a link to the ASL version
Post Secondary Educational Institution you plan to attend:*
Post Secondary Educational Institution's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tell us about yourself:*
If in ASL, please provide a link to the ASL version
Upload supporting images or files of required attachments 1) GPA and/or ACT scores; 2) Recommendation Letters (highly encouraged) and 3) Audiogram

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AGREEMENT of the JOHN JACOB DOLD SCHOLARSHIP TERMS by Applicant.

Must be signed before applications can be considered and awards given.
The JOHN JACOB DOLD SCHOLARSHIP TERMS

If I'm award with John Jacob Dold Scholarship, I agree by accepting this John Jacob Dold Scholarship and release the Kansas Association of the Deaf (KAD), and its officers, directors, and members from any liability, loss, damage, cost, or claim that arises from my participation in the Dold Scholarship program. KAD reserves the right to withhold funds in any given year, and to modify or terminate any fund at its sole discretion, with or without notice.

By accepting this scholarship, I give the Kansas Association of the Deaf (KAD) permission to publicly announce my name, image, award amount, and endeavor in any of its public relations materials.
To be signed by the recipient named as applicant. By signing this document, the recipient agrees to the John Jacob Dold Scholarship Terms:
Applicant Signature*

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Applicant Name*

First NameLast Name
SCHOLARSHIP AWARD NOTICE:

Scholarship Award Criteria: Awarding of scholarships is contingent upon the strength of the application, fund availability, the proposed individuals' endeavor merit, and the volume of applications received. Receipt of a scholarship is not guaranteed.

Confidentiality Assurance: Personal details such as age, address, and driver's license number are treated with utmost confidentiality and will not be disclosed. Information pertaining to the awarded endeavor may be shared publicly.

Selection Process: The KAD Board of Directors convenes as requests come in, to evaluate and vote by majority to approve the request.

Announcement of Winners: The KAD President will send a letter(s) with an award(s) to the selected recipient(s) with the instructions of contacting the Treasurer with information such as the student ID number and the address of the college/university where the check will be mailed to. Then the scholarship recipient(s) will be announced on KAD’s website, social media, and newsletter.
Should be Empty:

APPLICANT INFORMATION

AGREEMENT of the JOHN JACOB DOLD SCHOLARSHIP TERMS by Applicant.