HCAC DST 2019 Scholarship Application Form

HCAC Scholarship Application Form

Application Deadline - March 9, 2019
Read and follow the instructions carefully prior to submitting your application.

Delta Sigma Theta is a public service organization.

Children of members of DST are not eligible to apply.

HCAC grants both needs-based and merit scholarships.
HCAC of Delta Sigma Theta will not accept or consider incomplete, late, emailed, or faxed copies of the application, or application packets containing unofficial transcripts and/or handwritten essays.
Application Checklist
- Completed, signed and dated application
- Personal Data Sheet
- 1 Letter of Recommendation (Teachers, Counselors, Administrator)
- 1 Letter of Recommendation (Non-Related person of choice, not from school)
- Essay (1-2 pages typed, 12-pt font, double-spaced)
- Official transcript (first semester grades of senior year )
Scholarship Eligibility Requirements
Scholarship Eligibility Requirements
Applicants must be a graduating high school senior with a minimum ‘B’ cumulative numerical grade point average (80 percent or 2.5 GPA) and attending a public or private Henry County school. Children of members of DST are not eligible to apply. HCAC of Delta Sigma Theta Sorority, Inc. will only award scholarship funds upon receipt of official acceptance and enrollment documentation from a four-year accredited college or university. Enrollment must occur during the first semester of the upcoming school year and/or by December 1, 2019.

A complete application packet includes the following:

1. Application/Personal Data Sheet— completed, signed and typed. Do NOT submit a handwritten application.

2. An Official High School Transcript— includes first semester grades of the senior year and the school official seal.

3. Two (2) Letters of Recommendation—One (1) letter from a teacher, counselor and/or administrator on official letterhead and one (1) letter from a non-related individual whom you select from your community.

4. ESSAY – 1-2 pages, typed using a 12-point font, and double-spaced.

Topic selected is one of the three choices below:
- My career goals and how they will impact my community
- A person who has made a significant impact on my life and why
- An obstacle that I have overcome and how the experience will enhance my endeavors
Scholarship Selection Process
Scholarship Selection Process
All complete application packets will be reviewed, evaluated, and rated by a panel committee.

Candidates will be rated on:
Academic Achievement, Educational Goals/Career Plans, Extra-Curricular Activities, Essay, Leadership, Community Service and Interview

Candidates with complete packets will be interviewed by non-members of HCAC on March 30, 2019.
Scholarship Deadline
Application, documents and transcripts must be uploaded/submitted or mailed by

March 9, 2019

Henry County Alumnae Chapter

Delta Sigma Theta Sorority, Inc.

P.O. Box 787

McDonough, GA 30253-0787
Instructions/Tips for completing this online application

A) Please ensure you thoroughly complete this application.

B) All documents must be uploaded at the time of submission.

C) There is no option to save your application and submit it later.

D) Multiple submissions will be disqualified.

E) For required [*] fields that do not apply to you, please place "N/A" in those fields.

If you have questions regarding submitting your scholarship application prior to completing it, please email: Scholarship@hcacdst.org
Check off this list BEFORE YOU START!
- Completed, signed and dated application
- Personal Data Sheet
- 1 Letters of Recommendation (Teacher, Counselor, Administrator ) on school's letterhead
- 1 Letter of Recommendation (non-related person of choice, not from school)
- Essay (1-2 pages typed, 12-pt font, double-spaced)
- Official transcript (first semester grades of senior year) school seal.
Scholarship Applicant Acknowledgement
Read and Understand the instructions. *

Yes, I have read and understand the instructions, checklist and scholarship deadline

I. Personal Information:

If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence, award agreements and awards will be generated from the personal information submitted below. Please ensure all information is accurate and current, using proper spelling, capitalization and punctuation.
Full Name *

First Name Middle Name Last Name Suffix
High School : *
Social Security Number: *
Signature *

Please sign stating that you have read, understand and acknowledge that the use of your Social Security Number will only be for the purposes of the 2019 HCAC DST Scholarship. Clear
Place of Birth *
Birth Date: *

Month Day Year
Home Number : *

- Area Code Phone Number
Mobile Number : *

- Area Code Phone Number
Alternate Number : *

- Area Code Phone Number
Are you a US citizen? *

Yes No
E-mail : *
This email should be the email where your application confirmation will be sent to.

Home Address : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Permanent Mailing Address : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Emergency Contact : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Status at the time of application:

I will graduate from high school in May 2019 I will be an incoming freshman graduating high school prior to 2019 I am a GED graduate with no college credit hours

School Information
Name of High School : *
Grades Attended : *
Cumulative/Numerical Grade Point Average *
Weighted
Cumulative/Numerical Grade Point Average *
Unweighted

High School Address : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

School Phone : *

- Area Code Phone Number
School FAX : *

- Area Code Phone Number
Your Counselor's Name : *
Previous High School Attended (if different from current school) : *
Place "N/A" in this field if it does not apply to you

Previous High School Address : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Name of Middle School you attended : *

Address of Middle School you attended : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Personal Data Sheet

For each year of high school, list the activities and clubs you have been involved in and any leadership positions you held. Include extra-curricular and community activities; honors, awards and recognition. Include any cultural experiences and/or activities, and work experience.
FRESHMAN *
SOPHOMORE *
JUNIOR *
SENIOR *

Essay

This section allows you to upload your 1-2 pages typed, 12-pt font, double spaced, Word document Essay. Do not upload any video files, graphical imagery, slideshows or website URLs. An upload of any document other than a Word file will automatically disqualify your scholarship application.
Your Essay should be: 1-2 pages typed, 12-pt font, double spaced Word document.

Topic selected is one of the three choices below:
- My career goals and how they will impact my community
- A person who has made a significant impact on my life and why
- An obstacle that I have overcome and how the experience will enhance my endeavors
Upload your WORD document Essay > Click Browse Files

Browse Files
All files must follow the following file name sequence: First Name Last Name_High School_Grade Level_DESCRIPTION OF FILE [i.e. Reference Letter, Essay etc.] Cancel of
Essay: *

Recommendations Upload Section

This section allows you to upload your: 2 letters of recommendations
Browse Files
All files must follow the following file name sequence: First Name Last Name_High School_Grade Level_DESCRIPTION OF FILE [i.e. Reference Letter, Essay, Lunch Letter etc.] Cancel of

Official Transcript Upload Section

This section allows you to upload your official transcript with the seal
Browse Files
All files must follow the following file name sequence: First Name Last Name_High School_Grade Level_DESCRIPTION OF FILE [i.e. Reference --Letter, Essay, Lunch Letter, Official Transcript etc.] Cancel of

Lunch Letter (if applicable)

This section allows you to upload your Free Lunch Letter on official letterhead [If you receive free or reduced lunch, upload a letter of verification on school letterhead from an administrator or cafeteria manager]
Browse Files
All files must follow the following file name sequence: First Name Last Name_High School_Grade Level_DESCRIPTION OF FILE [i.e. Reference --Letter, Essay, Lunch Letter, Official Transcript etc.] Cancel of

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. 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.
I certify that the information that I have provided in this application is true and complete to the best of my knowledge. I fully realize that omission and/or falsification of information will be sufficient reason for rejection of my application.
Name *

First Name Middle Name Last Name Suffix
E-Signature *

Use your mouse to e-sign the signature box Clear
You MUST click the button below in order to submit your HCAC DST Scholarship Application.
Henry County Alumnae Chapter is committed to equal opportunity in employment and education. HCAC does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

HCAC Scholarship Application Form

Application Checklist

Scholarship Eligibility Requirements

Scholarship Selection Process

Scholarship Deadline

Scholarship Applicant Acknowledgement

I. Personal Information:

School Information

College Plans

Parent/Family and Demographical Information

Personal Data Sheet

Essay

Recommendations Upload Section

Official Transcript Upload Section

Lunch Letter (if applicable)

Applicant's E-Signature