Alpha Sigma State

Delta Kappa Gamma Society International

Scholarship Application for State Scholarship Funds (graduate work by members)

Name:__________________________________________________________Date:_____/_____/____

Address:___________________________________________________________________________

Phone:(_____)_____________Chapter:_______________________________Area:________________

Current position in education:____________________________________________________________

Current employer:____________________________________________________________________

Educational Background

BA/BS degree in:_____________________________________________________________________

College:____________________________________________________________________________

Master's degree in:____________________________________________________________________

College:____________________________________________________________________________

Other credentials/certificates/degrees:_______________________________________________________

____________________________________________________________________________________

Teaching experiences

Position:__________________________________________Level:___________Location:_____________

Position:__________________________________________Level:___________Location:_____________

Position:__________________________________________Level:___________Location:_____________

Studies for which award is requested

Degree/endorsement/certification/National Board Certification/credentials/for which you are applying:

 

College or other institution:____________________________________Location:______________________

Financial office address:___________________________________________________________________

Statement of financial need

(Money is not available for the full amount of applicants' needs, but it will be helpful to the committee to understand the financial requirements for the completion of the program you have described.)

Requirements ----------------------------Current Year's Need--------------Future

Tuition/Registration/Fees $___________ $_______________

Travel ------------------$___________ $_______________

Living Expenses---------$___________ $_______________

Thesis/Dissertation/Media/

Materials---------------- $___________ $_______________

Delta Kappa Gamma Activities

Chapter:________________________Year Initiated:_________ Current Office:_______________________

Offices and Chairmanships Held:____________________________________________________________

_____________________________________________________________________________________

State, Regional, or National Activities:________________________________________________________

_____________________________________________________________________________________

Recommendations

At least one letter of recommendation from professional associates, supervisors, or graduate advisors must be sent to the State Scholarship Committee chair. Please list their names and phone numbers or e-mail here.

1. ___________________________________________________________________________________

2.____________________________________________________________________________________

 

Information about Your Program of Study (may be completed on other paper to be attached to this form)

How will your studies help you contribute to the field of education?

 

 

How will your studies contribute to Delta Kappa Gamma Society International's purposes?

 

 

How will your studies contribute to your own personal and professional growth?

 

 

What are your personal and career goals when you complete this program?

 

 

 

 

Send by February 1 to Billie Hilton, 1825 South 68th Ave. Yakima, WA 98908

 

January 24, 2005
Irma Perez, Webmaster

Homepage/Scholarhips/Chapter President's Recommendation Form/State Scholarship Fund Stipend