2016KAPsiFoundation JacksonvilleApplication Package
Content
INSTRUCTIONS
1.
Complete this application form in its entirety. If you
need more space than provided on this form, you may
attach separate sheets of paper.
PLEASE TYPE OR PRINT NEATLY.
2.
Include all required attachments see (Required
Attachments” on the next panel) with your
completed application form. Any application forms
received without required attachments will be
ineligible.
3.
Send all materials to:
Dr. Mel C Norwood, II, Chairman
Scholarship Committee
P.O. Box 40625
Jacksonville, Florida 32203-0625
Your entry must be postmarked no later than
February 29, 2016. Entries postmarked after
February 29, 2016 will be ineligible.
ELIGIBILITY REQUIREMENTS
To be eligible to enter the Guide Right Scholarship and
Development Foundation program, you must meet all of the
following criteria:
1.
2.
3.
You must be a graduating High School Senior from
Duval, Clay, Nassau, or St. Johns County (FL) at the
time of application submission.
You must be a U.S. citizen.
You must be able to provide written acceptance to an
accredited college or university by no later than the
interview date.
4.
You must submit all required attachments with your
completed application form.
5.
Students are only eligible for one Kappa Alpha Psi
Foundation Jacksonville Fraternity Scholarship.
SELECTION CRITERIA
Applications will be selected based on:
1. Scholastic achievement (e.g., AP/honors classes,
grade point average, SAT, ACT or PERT scores)
2. Character and leadership (e.g., extra curricular
involvement, honors, awards, achievements,
personal reference)
3. Essay responses (communications skills,
personal insight), 2 recommendation letters
4. Personal Interview
REQUIRED ATTACHMENTS
Please include all of the following with your
completed application form. Any applications
submitted without the required attachments will be
ineligible.
1. Copy of high school transcripts with your GPA,
honors/AP classes, and SAT or ACT scores
noted.
2. Two letters of recommendation. One letter must be
from a teacher or school administrator and one
letter must be from a personal reference. Please be
certain that each letter has the references name,
address and phone number. References should
also included how long they have known you and in
what context.
3. Attach a Passport Photo with semi-formal attire.
AWARDS
Each Scholarship Recipient will receive four tickets
for their relatives to attend the Scholarship
presentation ceremony.
THE JACKSONVILLE ALUMNI
CHAPTER OF KAPPA ALPHA PSI
The Jacksonville Alumni Chapter of Kappa Alpha
Psi Guide Right Scholarship and Development
Foundation, Inc., provides scholarships to needy and
talented students. We also inform these same
students about professions and career options.
Kappa Alpha Psi’s commitment to youth is well
established. Our Guide Right efforts, both individual
and collective, serve as a mechanism that promotes
honorable achievement and inspires service in the
public interest.
The
Kappa Alpha Psi
Foundation Jacksonville
Scholarship
Application 2016
KAPPA ALPHA PSI FRATERNITY, INC.
Kappa Alpha Psi Fraternity, Inc., is one of the
leading service fraternities in the nation. Our vision
is to be the nation's preeminent fraternity, comprised
of a bastion of high achiever's and leaders working
to advance the social, civic, and economic well
being in our communities. Kappa Alpha Psi seeks to
train its membership, particularly undergraduates, for
leadership roles in their perspective communities and
the attainment of a high degree of excellence in their
academic pursuits.
HURRY AND COMPLETE TODAY!
ADDITIONAL REQUIREMENTS
FINAL JUDGING ROUND
If you are selected to proceed to the final
judging round, you will be notified of an interview.
Please be prepared to respond to the selection
criteria listed in the above section.
Application is also available online at
www.JacksonvilleKappas.com
PLEASE RETAIN A COPY
OF BOTH SIDES OF THIS
APPLICATION FORM
FOR YOUR RECORDS
ENTRY DEADLINE IS
February 29, 2016
Application is available online at
www.JacksonvilleKappas.com
JACKSONVILLE ALUMNI CHAPTER OF KAPPA ALPHA PSI
GUIDE RIGHT SCHOLARSHIP AND DEVELOPMENT FOUNDATION, INC.
2016 APPLICATION
(Please Type or Print Neatly)
1. STUDENT APPLICANT—LAST NAME
Deadline Monday, February 29, 2016
FIRST NAME
2. HOME ADDRESS—STREET
MIDDLE NAME
CITY
STATE
3. (AREA CODE) HOME PHONE
4. (AREA CODE) CELL PHONE
6. DATE
OF
BIRTH
7. EMAIL ADDRESS
MONTH/ DAY/ YEAR
ZIP
5. PLACE OF BIRTH
8.NAME OF LOCATION WHERE YOU RECEIVED THIS APPLICATION
Complete all questions
9. NAME: FATHER / MALE GUARDIAN
9. NAME: MOTHER / FEMALE GUARDIAN
ADDRESS
ADDRESS
CITY
STATE
ZIP
CITY
OCCUPATION
OCCUPATION
EMPLOYER
EMPLOYER
STATE
ZIP
10. LIST ALL OTHER DEPENDENTS IN YOUR HOUSEHOLD
NAME
RELATIONSHIP
AGE
(COLLEGE IF ENROLLED)
11. SPECIAL CIRCUMSTANCES ( PLEASE BE SPECIFIC)
12. HIGH SCHOOL(S) ATTENDED: LIST IN ORDER ALL SCHOOLS ATTENDED DURING LAST TWO YEARS
NAME OF SCHOOL
LOCATION
NAME OF SCHOOL
LOCATION
13. SAT OR ACT SCORE
14. CUMULATIVE GPA
15. NUMBER OF HONORS/AP STUDIES
16. LIST FOUR YEAR COLLEGE OR UNIVERSITIES YOU HAVE APPLIED TO FOR ADMISSION:
NAME OF SCHOOL
NAME OF SCHOOL
LOCATION
LOCATION
FIELD OF STUDY
HAVE BEEN ACCEPTED
YES
NO
FIELD OF STUDY
HAVE BEEN ACCEPTED
YES
NO
17. HONORS AND AWARDS: LIST ON A SEPARATE SHEET OF PAPER ANY SCHOLASTIC HONORS AND AWARDS RECEIVED. (EXTRA CURRICULAR ACTIVITIES (IN WHICH
YOU HAVE PARTICIPATED, INCLUDING SCHOLASTIC, CULTURAL, RELIGIOUS, ATHLETIC, CIVIC OR COMMUNITY ACTIVITIES).
18. EMPLOYMENT: LIST ON A SEPARATE SHEET OF PAPER YOUR EMPLOYMENT HISTORY, APPROXIMATE HOURS PER WEEK, HOURLY WAGE AND
NATURE OF WORK.
ESSAY
PLEASE ANSWER BOTH QUESTIONS ON A SEPARATE SHEET OF PAPER, NO MORE THAN 300 WORDS.
19. WHY IS EDUCATION IMPORTANT TO YOU?
20. IF YOU HAVE JUST BEEN ELECTED PRESIDENT OF THE UNITED STATES, WHAT WOULD BE THE MOST URGENT THING ON YOUR AGENDA AND
WHY?
STATEMENT OF UNDERSTANDING
I CERTIFY THAT EVERYTHING I HAVE STATED AND REPORTED IN THIS APPLICATION IS CORRECT TO THE BEST OF MY KNOWLEDGE AT THIS TIME. I UNDERSTAND
THAT THE JACKSONVILLE ALUMNI CHAPTER OF KAPPA ALPHA PSI GUIDE RIGHT SCHOLARSHIP AND DEVELOPMENT FOUNDATION, INC., WILL RETAIN THIS
APPLICATION AND ITS ENCLOSURES WHETHER OR NOT I AM SUCCESSFUL IN RECEIVING A GRANT. I FURTHER AGREE THAT ALL DECISIONS MADE BY THE
SELECTION COMMITTEE WILL BE FINAL.
SIGNATURE OF APPLICANT ______________________________________________________________DATE ______________________________________
SIGNATURE OF PARENT/GUARDIAN ______________________________________________________ DATE ———————————————————-
1.
Complete this application form in its entirety. If you
need more space than provided on this form, you may
attach separate sheets of paper.
PLEASE TYPE OR PRINT NEATLY.
2.
Include all required attachments see (Required
Attachments” on the next panel) with your
completed application form. Any application forms
received without required attachments will be
ineligible.
3.
Send all materials to:
Dr. Mel C Norwood, II, Chairman
Scholarship Committee
P.O. Box 40625
Jacksonville, Florida 32203-0625
Your entry must be postmarked no later than
February 29, 2016. Entries postmarked after
February 29, 2016 will be ineligible.
ELIGIBILITY REQUIREMENTS
To be eligible to enter the Guide Right Scholarship and
Development Foundation program, you must meet all of the
following criteria:
1.
2.
3.
You must be a graduating High School Senior from
Duval, Clay, Nassau, or St. Johns County (FL) at the
time of application submission.
You must be a U.S. citizen.
You must be able to provide written acceptance to an
accredited college or university by no later than the
interview date.
4.
You must submit all required attachments with your
completed application form.
5.
Students are only eligible for one Kappa Alpha Psi
Foundation Jacksonville Fraternity Scholarship.
SELECTION CRITERIA
Applications will be selected based on:
1. Scholastic achievement (e.g., AP/honors classes,
grade point average, SAT, ACT or PERT scores)
2. Character and leadership (e.g., extra curricular
involvement, honors, awards, achievements,
personal reference)
3. Essay responses (communications skills,
personal insight), 2 recommendation letters
4. Personal Interview
REQUIRED ATTACHMENTS
Please include all of the following with your
completed application form. Any applications
submitted without the required attachments will be
ineligible.
1. Copy of high school transcripts with your GPA,
honors/AP classes, and SAT or ACT scores
noted.
2. Two letters of recommendation. One letter must be
from a teacher or school administrator and one
letter must be from a personal reference. Please be
certain that each letter has the references name,
address and phone number. References should
also included how long they have known you and in
what context.
3. Attach a Passport Photo with semi-formal attire.
AWARDS
Each Scholarship Recipient will receive four tickets
for their relatives to attend the Scholarship
presentation ceremony.
THE JACKSONVILLE ALUMNI
CHAPTER OF KAPPA ALPHA PSI
The Jacksonville Alumni Chapter of Kappa Alpha
Psi Guide Right Scholarship and Development
Foundation, Inc., provides scholarships to needy and
talented students. We also inform these same
students about professions and career options.
Kappa Alpha Psi’s commitment to youth is well
established. Our Guide Right efforts, both individual
and collective, serve as a mechanism that promotes
honorable achievement and inspires service in the
public interest.
The
Kappa Alpha Psi
Foundation Jacksonville
Scholarship
Application 2016
KAPPA ALPHA PSI FRATERNITY, INC.
Kappa Alpha Psi Fraternity, Inc., is one of the
leading service fraternities in the nation. Our vision
is to be the nation's preeminent fraternity, comprised
of a bastion of high achiever's and leaders working
to advance the social, civic, and economic well
being in our communities. Kappa Alpha Psi seeks to
train its membership, particularly undergraduates, for
leadership roles in their perspective communities and
the attainment of a high degree of excellence in their
academic pursuits.
HURRY AND COMPLETE TODAY!
ADDITIONAL REQUIREMENTS
FINAL JUDGING ROUND
If you are selected to proceed to the final
judging round, you will be notified of an interview.
Please be prepared to respond to the selection
criteria listed in the above section.
Application is also available online at
www.JacksonvilleKappas.com
PLEASE RETAIN A COPY
OF BOTH SIDES OF THIS
APPLICATION FORM
FOR YOUR RECORDS
ENTRY DEADLINE IS
February 29, 2016
Application is available online at
www.JacksonvilleKappas.com
JACKSONVILLE ALUMNI CHAPTER OF KAPPA ALPHA PSI
GUIDE RIGHT SCHOLARSHIP AND DEVELOPMENT FOUNDATION, INC.
2016 APPLICATION
(Please Type or Print Neatly)
1. STUDENT APPLICANT—LAST NAME
Deadline Monday, February 29, 2016
FIRST NAME
2. HOME ADDRESS—STREET
MIDDLE NAME
CITY
STATE
3. (AREA CODE) HOME PHONE
4. (AREA CODE) CELL PHONE
6. DATE
OF
BIRTH
7. EMAIL ADDRESS
MONTH/ DAY/ YEAR
ZIP
5. PLACE OF BIRTH
8.NAME OF LOCATION WHERE YOU RECEIVED THIS APPLICATION
Complete all questions
9. NAME: FATHER / MALE GUARDIAN
9. NAME: MOTHER / FEMALE GUARDIAN
ADDRESS
ADDRESS
CITY
STATE
ZIP
CITY
OCCUPATION
OCCUPATION
EMPLOYER
EMPLOYER
STATE
ZIP
10. LIST ALL OTHER DEPENDENTS IN YOUR HOUSEHOLD
NAME
RELATIONSHIP
AGE
(COLLEGE IF ENROLLED)
11. SPECIAL CIRCUMSTANCES ( PLEASE BE SPECIFIC)
12. HIGH SCHOOL(S) ATTENDED: LIST IN ORDER ALL SCHOOLS ATTENDED DURING LAST TWO YEARS
NAME OF SCHOOL
LOCATION
NAME OF SCHOOL
LOCATION
13. SAT OR ACT SCORE
14. CUMULATIVE GPA
15. NUMBER OF HONORS/AP STUDIES
16. LIST FOUR YEAR COLLEGE OR UNIVERSITIES YOU HAVE APPLIED TO FOR ADMISSION:
NAME OF SCHOOL
NAME OF SCHOOL
LOCATION
LOCATION
FIELD OF STUDY
HAVE BEEN ACCEPTED
YES
NO
FIELD OF STUDY
HAVE BEEN ACCEPTED
YES
NO
17. HONORS AND AWARDS: LIST ON A SEPARATE SHEET OF PAPER ANY SCHOLASTIC HONORS AND AWARDS RECEIVED. (EXTRA CURRICULAR ACTIVITIES (IN WHICH
YOU HAVE PARTICIPATED, INCLUDING SCHOLASTIC, CULTURAL, RELIGIOUS, ATHLETIC, CIVIC OR COMMUNITY ACTIVITIES).
18. EMPLOYMENT: LIST ON A SEPARATE SHEET OF PAPER YOUR EMPLOYMENT HISTORY, APPROXIMATE HOURS PER WEEK, HOURLY WAGE AND
NATURE OF WORK.
ESSAY
PLEASE ANSWER BOTH QUESTIONS ON A SEPARATE SHEET OF PAPER, NO MORE THAN 300 WORDS.
19. WHY IS EDUCATION IMPORTANT TO YOU?
20. IF YOU HAVE JUST BEEN ELECTED PRESIDENT OF THE UNITED STATES, WHAT WOULD BE THE MOST URGENT THING ON YOUR AGENDA AND
WHY?
STATEMENT OF UNDERSTANDING
I CERTIFY THAT EVERYTHING I HAVE STATED AND REPORTED IN THIS APPLICATION IS CORRECT TO THE BEST OF MY KNOWLEDGE AT THIS TIME. I UNDERSTAND
THAT THE JACKSONVILLE ALUMNI CHAPTER OF KAPPA ALPHA PSI GUIDE RIGHT SCHOLARSHIP AND DEVELOPMENT FOUNDATION, INC., WILL RETAIN THIS
APPLICATION AND ITS ENCLOSURES WHETHER OR NOT I AM SUCCESSFUL IN RECEIVING A GRANT. I FURTHER AGREE THAT ALL DECISIONS MADE BY THE
SELECTION COMMITTEE WILL BE FINAL.
SIGNATURE OF APPLICANT ______________________________________________________________DATE ______________________________________
SIGNATURE OF PARENT/GUARDIAN ______________________________________________________ DATE ———————————————————-
