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Alpha Phi Alpha Fraternity, Inc.

Kappa Sigma Lambda Chapter


P.O. Box 397
Killeen, Texas 76541

Scholarship Application
Cover Page

Upon completion of application, return it to your Guidance


Counselor or mailed to the above address by April 1, 2008.
Applications received after this date will not be considered.
Ensure that this cover sheet is included with your application
when you submit it.

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Date application received: _______________

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APPLICATION
FOR
ALPHA PHI ALPHA FRATERNITY
SCHOLARSHIP AWARD
ACADEMIC YEAR 2007-2008

1. NAME: ____________________________________________________
(FIRST) (MIDDLE) (LAST)

2. ADDRESS: _________________________________________________

________________________________________________

3. PHONE: ____________________________

4. DATE OF BIRTH: ___/___/____


M D YR

5. RACE/NATIONAL ORIGIN: ____________________________

6. SCHOOL PRESENTLY ATTENDING: _______________________________

7. SCHOOL ADDRESS: _____________________________________________

8. GUIDANCE COUNSELOR: ___________________ PHONE: ____________

9. A. CURRENT GRADE POINT AVERAGE: _____________

B. CIRCLE THE APPROXIMATE LETTER VALUE FOR THE AVERAGE CITED


ABOVE: A+ A A- B+ B B- C+ C C-

C. COLLEGE BOARD SCORES (SAT): VERBAL ____ MATH ____ COMP ___
(ACT):

D. RANK IN CLASS: ____ OUT OF ____

ALL APPLICANTS ARE REQUIRED TO SUBMIT A RECENT OFFICIAL COPY


OF THEIR TRANSCRIPTS TO VERIFY THE ABOVE INFORMATION.

10. LIST ANY ACADEMIC HONORS OR ACHIEVEMENTS RECEIVED DURING


HIGH SCHOOL:

_________________________________________________________

_________________________________________________________

_________________________________________________________

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_________________________________________________________

11. LIST THOSE ORGANIZATIONS WHICH YOU PARTICIPATED IN DURING


HIGH SCHOOL. INCLUDE DATES OF PARTICIPATION AND ANY
POSITION HELD.
_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

12. LIST ANY COMMUNITY OR CHURCH AFFILIATED INVOLVEMENT OUTSIDE


OF SCHOOL. INCLUDE ANY POSITIONS THAT YOU HOLD.
_________________________________________________________

_________________________________________________________

_________________________________________________________

13. A. NAME OF PARENTS OR LEGAL GUARDIANS:


FATHER MOTHER

_________________________ _________________________

B. OCCUPATIONS OF PARENTS/GUARDIANS:

_________________________ _________________________

C. PARENTS EMPLOYER:

_________________________ _________________________

14. NUMBER OF BROTHERS AND SISTERS: _____ AGES: _____________

15. LIST THE NAMES AND COLLEGES WHICH YOU HAVE BEEN ACCEPTED IN
ORDER OF PREFERENCE:

__________________________________________________

__________________________________________________

__________________________________________________

16. WHAT COURSE OF STUDY WILL YOU PURSUE IN COLLEGE?

_______________________________________________

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17. WHAT IS YOUR EVENTUAL CAREER CHOICE?

_______________________________________________

18. WHAT RESOURCES DO YOU HAVE TO PAY FOR YOUR COLLEGE EXPENSES?

A. PERSONAL SAVINGS $ _____________

B. EMPLOYMENT $ ___________/MONTH

C. PARENTAL CONTRIBUTION $ ___________/MONTH

D. OTHER FINANCIAL AID $ _____________


(PLEASE SPECIFY)

19. LIST THREE PERSONS IN RESPONSIBLE POSITIONS WHO CAN ATTEST


TO YOUR PERSONAL CHARACTER,ABILITIES,AND QUALIFICATIONS.
AT LEAST ONE OF THESE REFERENCES SHOULD NOT BE ASSOCIATED
WITH YOUR HIGH SCHOOL.

NAME: ________________________________

POSITION: ___________________________ PHONE: ______________

NAME: ________________________________

POSITION: ___________________________ PHONE: ______________

NAME: ________________________________

POSITION: ___________________________ PHONE: ______________

20. ON A SEPARATE SHEET, PLEASE STATE IN 100 TO 200 WORDS, WHY


YOU SHOULD BE CONSIDERED FOR THE ALPHA PHI ALPHA FRATERNITY
SCHOLARSHIP AWARD. PLEASE INCLUDE THIS NARRATIVE WITH YOUR
APPLICATION.

I CERTIFY THAT THE INFORMATION CITED HEREIN, AND WHICH I


AUTHORIZE YOU TO VERIFY IS TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE.

SIGNATURE OF APPLICANT: _______________________ DATE: __________

SIGNATURE OF PARENT/GUARDIAN: ___________________ DATE: _________

THE INFORMATION SUPPLIED BY THE APPLICANT WILL BE HELD IN THE


STRICTEST CONFIDENCE AND WILL BE SHARED ONLY WITH THOSE PERSONS

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DIRECTLY INVOLVED WITH THE SCHOLARSHIP SELECTION PROCESS.

PLEASE RETURN APPLICATIONS TO YOUR SCHOOL’S GUIDANCE COUNSELOR’S


OFFICE OR MAIL NO LATER THAN APRIL 1, 2008 TO:

ALPHA PHI ALPHA FRATERNITY, INC.


KAPPA SIGMA LAMBDA CHAPTER
P.O. BOX 397
KILLEEN, TX 76541

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