2026 PAMALA ANN RAPLEY NURSING SCHOLARSHIP APPLICATION

Congratulations on reaching this academic milestone!

Delta Sigma Theta Sorority, Inc. is an organization dedicated to aiding in the education of talented youth throughout our community.

Requirements for the scholarship, application, and media waiver are included below.

We wish you success as you continue your academic career!

NURSING SCHOLARSHIP ELIGIBILITY CRITERIA:

Must be an African-American female.
Must have a minimum unweighted G.P.A of 3.0 on a 4.0 scale.
Must demonstrate community involvement which will be assessed by the number of volunteer/community service hours listed on the transcript (or other documentation).
Must graduate from a Duval, St. Johns, and Nassau County (public, private, or charter) high school at the end of the 2025-2026 academic school year.
Must attend an accredited institution of higher education after graduation and enroll as a full-time student with major in the Nursing field.
Must provide an official high school transcript (should include ACT and/or SAT scores).
Must submit two (2) typed letters of recommendation (from non-family members):
- One (1) letter must be from a high school staff member.
- One (1) letter must be from an organization in which you have performed community service.
- Both letters must be signed by submitter (electronic signature is acceptable) on the appropriate organization’s letterhead.
Must submit a typed, double spaced 1-page 500-word maximum essay using 12-point Times New Roman font.
- The essay should also include how your studies and achievements have prepared you for your future goals.
- The submission should demonstrate the applicant’s knowledge based on topic, research skills, creativity, and proper use of the English language.
- The essay should include how applicant’s studies and achievements have prepared them for your future goals.
- Applicant’s submission MUST respond to the following topic:

What specific area do you plan to study? Tell us why you’ve decided to pursue nursing and how you hope to make a difference in the field.

Student and parent/guardian must complete and sign the scholarship application no later than February 14, 2026.
Student and parent/guardian must sign the attached Dependent Acknowledgement Waiver and Media Waiver.

Name*

First NameLast Name

Date of Birth*

Gender*

femalemale

Email*

example@example.com

Address*

Street Address Line 1

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone Number*

Area CodePhone Number

Home Phone Number

Area CodePhone Number

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Email*

example@example.com

Parent/Guardian Cell Phone Number*

Area CodePhone Number

Parent/Guardian Work Phone Number

Area CodePhone Number

Is your parent/guardian a member of Delta Sigma Theta Sorority, Inc.? *

If you answered YES, please STOP HERE. You are ineligible for the scholarship.

High School*

School Counselor Name*

First NameLast Name

SAT (Total Score)*

ACT (Total Score)*

Unweighted GPA*

PLEASE READ THE FOLLOWING STATEMENTS AND SIGN BELOW: The information provided in my application packet is, to the best of my knowledge, complete and accurate. I understand that any false statements in this application may disqualify me from consideration of the scholarship award(s). I also understand and agree that any and all information submitted as part of this application packet will become property of the Jacksonville Alumnae Chapter of Delta Sigma Theta Sorority, Inc., and will be kept confidential. By signing below, I agree to accept the decision of the scholarship committee.

Applicant Name*

First NameLast Name

Applicant Signature*

First and Last Name

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Signature*

First and Last Name

DEPENDENT ACKNOWLEDGEMENT WAIVER: I, the undersigned parent/guardian of the above-referenced applicant/participant, acknowledge that she/he is my dependent and that she/he is NOT a dependent of a member of Delta Sigma Theta Sorority, Inc., (locally, nationally, or at-large). I understand that dependents of members of Delta Sigma Theta Sorority, Inc., are ineligible to participate in the scholarship and cannot receive scholarship funds. If it is determined that the above-referenced applicant/participant is a dependent of a member of Delta Sigma Theta Sorority, Inc., any scholarship funds awarded and/or received will be forfeited and must be immediately returned in full to the Jacksonville Alumnae Chapter of Delta Sigma Theta Sorority, Inc. BY MY SIGNATURE, I AM INDICATING THAT I HAVE READ AND UNDERSTAND THE FOREGOING INFORMATION.

Applicant Name*

First NameLast Name

Applicant Signature*

First and Last Name

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Signature*

First and Last Name

MEDIA WAIVER: I, the parent/guardian of the above-referenced applicant/participant consent to the release of photographs, videos, audio and other related recorded materials captured during the scholarship awards program. Such materials shall remain the sole property of the Jacksonville Alumnae Chapter of Delta Sigma Theta Sorority, Inc., and shall not be sold to any entity. BY MY SIGNATURE, I AM INDICATING THAT I HAVE READ AND UNDERSTAND THE FOREGOING INFORMATION.

Applicant Name*

First NameLast Name

Applicant Signature*

First and Last Name

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Signature*

First and Last Name

High School Transcript*

Browse Files

SAT and/or ACT Documentation (if not listed on transcript)

Browse Files

Documented Proof of Volunteer/ Community Service Hours (if the hours are not listed on the transcript)

Browse Files

Letter of Recommendation (High School Staff Member)*

Browse Files

Letter of Recommendation (Community Service Organization)*

Browse Files

Essay*

Browse Files

Headshot Photo (Selfies will not be accepted)*

Browse Files

Thank you for taking the time and initiative to apply.

Due to the high volume of submissions, we’re unable to respond individually to every applicant.

If you do not hear from us by March 16, 2026, please note that we will not be moving you forward in the application process.

We appreciate your understanding and will be cheering you on from afar.

PAMALA ANN RAPLEY NURSING SCHOLARSHIP APPLICATION

Please complete the form below.