Xi Chapter
2016 Awards Committee
P.O. Box 44
Syracuse, NY 13205
March 29, 2016
Dear Counselor/Community Leader:
Xi Chapter of Lambda Kappa Mu Sorority, Inc., an organization of business and professional
women, is accepting applications for the Carolyn Tyler Memorial Scholar Incentive Award
for 2016. We are soliciting your help in publicizing this award and making the application
enclosed available to all eligible students. To be eligible for this award, students must be an
African American/Black female high school senior graduating from a school in Onondaga
County and planning to attend an institution of higher learning.
We have presented the Carolyn Tyler Memorial Scholar Incentive Award annually since 1970.
The amount of the Award is $1,000.00 and a new recipient is selected each year. The award is
renewable for three consecutive years for a maximum amount of $4,000.00.
Enclosed you will find an application and selection criteria. The committee will only review
those applications that are complete. We ask your support in duplicating and distributing the
applications and assisting students in submitting a complete packet. The deadline for applying
for the Carolyn Tyler Memorial Scholar Incentive Award is May 2, 2016. Students must
adhere to this deadline. The award will be presented at our Youth Achievement awards
Luncheon on June 11, 2016 at Drumlins Country Club.
As always, your support is very much appreciated. Please contact me with questions regarding
the scholarship by email at tamarahamilton76@gmail.com or phone at 315.420.5387.
Sincerely,
Tamara N. Hamilton
Awards Committee Co-Chair
Lambda Kappa Mu Sorority, Incorporated
Xi Chapter
Syracuse, New York
Carolyn Tyler Memorial Scholar Incentive Award
GRANT:
$1,000.00 per year for a maximum of $4,000.00
Award is renewable each year. Recipient must maintain good academic standing (as defined by the
college/university/school) and submit proof of continuous enrollment.
ELIGIBILITY:
• An African American/Black female high school senior in Onondaga County, New York
•
Accepted to an institution of higher learning: College, paraprofessional, trade or professional
school (2 or 4 year institution)
•
Demonstrate evidence of financial need (see application)
TO APPLY, PLEASE SUBMIT BY THE DEADLINE:
• A completed application form
• Three (3) reference letters/letters of recommendation
• Official transcript
• An Activity Sheet/Résumé
• A personal statement including future goals, how the Award will be beneficial to your
academic success and how the Award will be used to benefit others
APPLICATION DEADLINE: Monday, May 2, 2016
MAIL COMPLETED APPLICATION PACKETS TO:
Tamara N. Hamilton
Awards Committee Co-Chair
P.O. Box 44
Syracuse, NY 13205
tamarahamilton76@gmail.com
ONLY COMPLETE APPLICATION PACKETS WILL BE REVIEWED
Xi Chapter – Lambda Kappa Mu Sorority, Inc.
Carolyn Tyler Scholar Application
Please type directly on application and answer all questions completely. Your information will be
kept confidential.
PERSONAL DATA
Name __________________________________________________________________________________
Address ________________________________________________________________________________
Phone (H) __________________________________
(C) ______________________________________
E-mail address ___________________________________________________________________________
Date of Birth _________________________
City/State of Birth _________________________________
Do you have a diagnosed physical or mental disability? (Y/N) ___________
If “Yes”, please explain
_______________________________________________________________________________________
EDUCATIONAL/COMMUNITY INFORMATION
High School(s) Attended (Most recent school first)
School
Address
Years
Date of Graduation
_______________________________________________________________________________________
_______________________________________________________________________________________
Extramural Activities (School activities and offices held) _________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Community Involvements (Church, Club activities and offices held) ________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
*Please attach an Activity Sheet/Résumé
COLLEGE/UNIVERSITY/SCHOOL INFORMATION
Name of Institution _______________________________________________________________________
Field of study ____________________________________________________________________________
Proposed Date of Enrollment/Matriculation ____________________________________________________
Have you been accepted to this institution? (Y/N) ___________ Full-time or Part-Time ________________
Are you the first person in your immediate family to attend college? (Y/N) ___________________________
Have either of your parents/guardians graduated from college? (Y/N) _______________________________
FINANCIAL INFORMATION
What are your anticipated school expenses and what resources do you have to meet the cost of attendance?
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Will you receive financial aid? (Y/N) _____________
If “Yes”, please list source(s) and amount(s) of aid
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Parents/Guardians Information
Father Name ___________________________________ Address __________________________________
Place of Employment ____________________________ Occupation _______________________________
Mother Name __________________________________ Address __________________________________
Place of Employment ____________________________Occupation ________________________________
Annual Gross Income of Family _________________________ Number of School Age Children in
Household _____________ Number Attending College ___________________
REFERENCES/RECOMMENDATIONS
Please list the names of three (3) references/recommenders [One (1) reference must be from a person outside
of the school (i.e., employer, community representative, etc.)]
NAME
ADDRESS
PHONE
TITLE/POSITION
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
PERSONAL STATEMENT
On a separate sheet, please include a one (1) page typed statement describing your future education goals
and profession. The statement should include how you will benefit from receiving the Carolyn Tyler Award
and how you will use this Award to benefit others. Please include any extenuating circumstances you will
like the committee to consider.
By signature below, I certify that I am eligible to apply for the Carolyn Tyler Scholar Award and that all
information in this application is correct and complete to the best of my knowledge.
Signature ___________________________________________________ Date ______________________
APPLICATION DEADLINE: Monday, May 2, 2016
MAIL COMPLETED APPLICATION PACKETS TO:
Tamara N. Hamilton
Awards Committee Chair
P.O. Box 44
Syracuse, NY 13205
tamarahamilton76@gmail.com
ONLY COMPLETE APPLICATION PACKETS WILL BE REVIEWED