Kappa Alpha Psi Foundation - Jacksonville

P.O. Box 40625 - Jacksonville, FL 32203

Scholarship Application Checklist

Entry Deadline Tuesday, January 31, 2017
A completed application must include all of the following

Provide a response to all questions on the application

Essay 1 Why is education important to you?
Essay 2 If you have just been elected President of the United State, then what would be the
most urgent thing on your agenda and why?

Copy of ACT, SAT, or PERT Scores. An unofficial copy is acceptable.

Official copy of High School Transcript
Letter of Recommendation from a teacher, counselor, or school administrator
Letter of Recommendation from a personal reference
Passport Size photo (2 x 2) in professional, business, or semi-formal attire
Please note the important dates below. In order to be considered for an award, applicants must be
available on each of these dates. Exact times and locations will be shared as applicants move
through the process.
Saturday, March 18, 2017
Saturday, March 25, 2017
Week of April 3, 2017
Thursday, April 20, 2017
Thank you for your interest in our scholarship program.

Dr. Mel C Norwood, II, Chair,

Scholarship Committee

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

January 31, 2017. Entries postmarked after
January 31, 2017 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 Psis 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 2017

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
January 31, 2017
Application is available online at
www.JacksonvilleKappas.com

JACKSONVILLE ALUMNI CHAPTER OF KAPPA ALPHA PSI

GUIDE RIGHT SCHOLARSHIP AND DEVELOPMENT FOUNDATION, INC.

2017 APPLICATION

Deadline Tuesday, January 31, 2017

(Please Type or Print Neatly)

1. STUDENT APPLICANTLAST NAME

FIRST NAME

2. HOME ADDRESSSTREET

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 COURSES

16. LIST THE COLLEGES AND UNIVERSITIES TO WHICH YOU HAVE APPLIED:

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?
21. ARE YOU NOW OR HAVE YOU EVER BEEN A MEMBER OF THE JACKSONVILLE (FL) ALUMNI CHAPTER KAPPA LEAGUE PROGRAM? ________________

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 -