Chicago North Shore Alumnae Panhellenic Association Scholarship Application

Personal Data

Tell us about you!
Full Name:*

First NameMiddle NameLast Name
Birthdate:*

MonthDayYear
Home Address :*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail :*
The confirmation will also be sent to this email address.
Mobile No. :*

Area CodePhone Number
Addt'l Phone:

Area CodePhone Number
This phone number is

Home Number (Land Line)Other (e.g. either parents' moblie number, work, friend, etc.)
Parents' Names:
College or University Enrolled (Identify city & state)
I have been accepted, but have not yet enrolled at the following College or University:
I give permission for my name to be publicized if I am awarded a CNSAPA scholarship.*

yesno
Academic Achievement
Name of High School
Please attach your transcript, including GPA. If school will not provide students with official transcripts,
the school can email transcript to info@northshorepanhellenic.net or mail to: Veronica Toussaint,
Vice President, CNSAPA, 3125 Sandy Ln., Glenview, IL 60026.
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GPA
ACT Score
SAT Score Verbal/Math/Total
How many SEMESTERS of AP classes have you completed?
How many AP classes are you taking THIS semester?
How many SEMESTERS of Honors or Accelerated classes have you completed?
How many Honors or Accelerated classes are you taking THIS semester?
Major Area of Study:
Please indicate what your major area of study will be.
If chosen field is not listed above, please list it here.
Why have you chosen this field of study?

0/300
Activities
High School Activities/Involvement. Please include dates and leadership positions held.
Volunteer Experience. Please include dates and leadership positions held.
Awards, Honors and Recognition. Please include dates.
Work Experience. Please include dates.
Interests, Hobbies and Talents
The College Experience
How will the college/university you attend be affected by your attendance and participation?
References/Recommendations
TWO reference/recommendation letters are required – one Academic and one Personal.
Preferred filetypes are: .pdf, .jpg, .jpeg, .doc or .docx Acceptable filetypes include: zip, mp3, mp4, wma, .tif, .png, and .gif

The personal reference/recommendation letter should come from someone unrelated to the applicant and someone she does not know through her school. Examples include an employer, program manager, fellow volunteer, etc. The person writing this personal reference letter should not be a peer.
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The academic reference/recommendation letter will be someone who the applicant knows through school, such as a
teacher, counselor, coach, etc. The person who writes this academic reference letter should not be a fellow student.
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Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are
the person completing this application. After pressing 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.
E-Signature:*
Type Name*

First NameLast Name
Should be Empty:

Personal Data

Academic Achievement

Activities

The College Experience

References/Recommendations

Applicant's E-Signature