It is our goal to assist fellow Delta Kappa Gamma sisters to enhance their professional and personal development.

Name: ________________________________________________Date:___________________________

Address:___________________________________________________Phone:(___)_________________

Chapter:____________________________________________Are you retired?_____________________

If teaching, please give current position and employer:____________________________________________

____________________________________________________________________________________

Degrees held:

Bachelors________Masters_______Doctorate_______Other credentials____________________________

Years as Delta Kappa Gamma member:_____________Offices Held:_______________________________

____________________________________________________________________________________

Two recommendations from chapter members must accompany this application or be sent by e-mail. The recommendations need to include information about your past and present participation and contribution to Delta Kappa Gamma. You may use the President's Recommendation form for the State Scholarship application, or have the members submit a letter to the State Scholarship Committee chairman. Please list the names and contact information of the members sending the recommendations:_________________________________________

_____________________________________________________________________________________

This request is for: Specialized Study_____Workshop_____Elder Hostel_____Other_____________________

Name of class/event______________________________________________________________________

Location:________________________________________Dates:_________________________________

Cost of class:_____________________________Other costs:____________________________________

Amount Requested:___________________________

On a separate sheet of paper, please describe your specialized study, and explain:

1) What contribution it will make to you as a person and as a professional?

2) What contribution it will make to education?

3) What contibution it will make to Delta Kappa Gamma Society International (including chapter)?

Funds are available for reimbursement as well as future events; in both cases, receipts or cancelled checks must be submitted to verify attendance. Members may not apply in consecutive years.

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

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

Webmaster, Irma Perez

December 3, 2005