You are on page 1of 1

GRANT IN AID SCHOLARSHIP APPLICATION FORM

Delta Chapter, District VI, Beta State


Southeast Region, Monroe County
Application Deadline: February 3, 2022
Scholarship Amount: $500

Instructions: Please print clearly the following information. Turn in completed application with essays attached to
your high school counselor.

Name_____________________________________________________________________________________
Address___________________________________City___________________State_______Zip_____________
Phone Number__________________________E-mail_______________________________________________
School______________________________________ACT score_______GPA_______Rank in Class___________
School Organizations/Activities (include any offices held)_____________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Community and/or Church Activities_____________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________

___________________________________________________________________________________________

Attach your typed essay answers to your application.

A) Using 1-2 paragraphs describe why you have chosen education as a career choice.
B) Using 1-2 paragraphs describe how the scholarship will benefit you and/or how you would use the scholarship
money if you are awarded the scholarship.

You are required to have one letter of recommendation submitted on your behalf. The letter should be submitted by a
high school teacher who can analyze your abilities and academic promise. Letters are to be attached in a sealed
envelope.

Student Signature_________________________________________________Date_______________________

Counselor Signature_______________________________________________Date_______________________

*Scholarship applicants should be pursuing education as a career choice.

You might also like