Central Jersey Alumnae Chapter of Delta Sigma Theta Sorority, Inc.
2016 Minerva Scholarship*
This scholarship is awarded to male and female
African-American high school SENIOR students ONLY.
Please type and complete this application in its entirety.
I.
Personal
Name
Date of Birth
M
Sex:
F
Address
Street
Phone
(
City
)
County
Alternate Phone
(
Zip
)
E-mail Address
High School
High School Counselor
Current GPA
SAT Scores (actual)
(on 4.0 scale)/Current Percentage
Critical Reading
(100% scale)
Math
*Please send an official transcript
ACT Scores
Please provide verification of SAT/ACT Scores
II.
School & Community Activities
Organizations
Dates Active
Honors/Awards received while attending high school
Office(s) Held
Contact Person
Central Jersey Alumnae Chapter of Delta Sigma Theta Sorority, Inc.
2016 Minerva Scholarship*
This scholarship is awarded to male and female
African-American high school SENIOR students ONLY.
III.
Financial Information (all financial information will be kept confidential)
Father’s Name
Address
Street
City
Employer
Annual Income
County
Zip
Occupation
(Please attach 2015 completed tax return or 2015 W-2/1099 form )
$
Dates of Employment
From
/
/
To
/
/
Mother’s Name
Address
Street
City
Employer
Annual Income
County
Zip
Occupation
(Please attach 2015 completed tax return OR 2015 W-2/1099 form)
$
Dates of Employment
From
/
Dependents in Household: (Please include applicant.)
Name
Age
/
To
Relationship
/
Grade in School
/
Central Jersey Alumnae Chapter of Delta Sigma Theta Sorority, Inc.
2016 Minerva Scholarship*
This scholarship is awarded to male and female
African-American high school SENIOR students ONLY.
Financial Information (cont’d)
Have you applied for financial aid?
Yes
No
Do you have any special financial circumstances that may affect your financial need?
List other scholarships and/or grants (use additional paper if necessary)
Name
Amount of Award
Detail how you will finance your education.
Parents
%
Personal Savings
%
Summer/Part-time Work
%
Other (Specify)
%
Received (Y/N)
Central Jersey Alumnae Chapter of Delta Sigma Theta Sorority, Inc.
2016 Minerva Scholarship*
This scholarship is awarded to male and female
African-American high school SENIOR students ONLY.
IV.
College Information
Anticipated Major
List all colleges to which you have applied and related expenses
College & State
V.
Expenses
Accepted (Y/N)
Personal Statement
Include career interest, goals, qualifications for this scholarship and any other information that may assist us in awarding you this
scholarship (use additional paper if necessary).
Central Jersey Alumnae Chapter of Delta Sigma Theta Sorority, Inc.
2016 Minerva Scholarship*
This scholarship is awarded to male and female
African-American high school SENIOR students ONLY.
VI. Essay
Choose ONE of the topics below and write a 500-word essay (typed and double spaced).
1. In your opinion, what is the number one issue affecting the African American community?
2. When President Obama leaves office in your opinion what will be his greatest accomplishment(s)? Explain why.
3. Technology has become vital in our modern society. It acts as both a source for knowledge and for enjoyment. Think
about technology’s role and connection with education. Does it help or hinder education? Provide an argument to
convince your town’s school board to accept your view of technology and its role in your school.
.
VII. Please read and sign:
I am willing to appear for a personal interview as a requirement for consideration for this scholarship award.
Date
/
/
Student Signature
Application Checklist
I have included the following: (please check each to confirm)
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Completed Application (Typed)
Official Transcript (Sent directly to CJA)
Verification of SAT/ACT Scores
Parental Tax Information (2015 Return(s) OR 2015 1099/W-2(s))
Personal Statement
Essay
Signature on Application
Two (2) Letters of Recommendation, one must be from a teacher or counselor (included OR mailed to the Committee
separately)
Send all materials to:
Central Jersey Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
P.O. Box 694
South Plainfield, NJ 07080-0694
If you have questions, please contact Denise Cliatt or Jill Johnson at scholarship@cjadeltas.org.
*****Applications must be postmarked no later than
February 26, 2016*****