Fillable East St. Louis Alumnae Chapter

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East St. Louis Alumnae Chapter

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East St. Louis Alumnae Chapter
Delta Sigma Theta Sorority, Inc.
1012 S. 15th Street
East St. Louis, Illinois 62207
Pamela M. Weston, Chapter President
2022 ESLAC
Past Presidents Educational
Book Scholarship Award
Questions regarding this scholarship application should be directed to:
ESLAC Education & Scholarship Committee at eslacedu@gmail.com
2022 ESLAC Past Presidents Educational Book Scholarship Application
Page 2 of 7
Scholarship Application and Instructions
The ESLAC Past Presidents Educational Book Scholarship Award was established by the East St. Louis
Alumnae Chapter Past Presidents of Delta Sigma Theta Sorority, Incorporated in 2017.
The ESLAC Past Presidents EDUCATIONAL BOOK SCHOLARSHIP AWARD is awarded annually to deserving
graduating African-American female seniors in the East St. Louis Metro East community who will attend a 4-year
college/university in the fall or immediately upon graduation. Disbursement of the scholarship funds will occur in
the fall, upon verification of acceptance and enrollment in a college or university. Failure to provide verification
of acceptance and enrollment will result in the forfeiture of the scholarship. This scholarship is a one-time
award in the amount of $500.00 and should be used specifically for the purchase of books and is not
deferrable or transferable.
All Scholarship Awards will be communicated by March 31, 2022.
Applicants must meet the following criteria:
1. Be a graduating African-American high school senior (female) within the following communities: St.
Clair and Madison County, having attended public high school for the past two years.
2. Have a minimum of 2.8/4.0 Grade Point Average.
3. Submit an academic transcript.
4. Submit ACT/SAT scores.
5. Submit a completed typewritten application. The form is a fillable PDF that can be completed on your
computer.
6. Submit two (2) letters of recommendation (forms included in application packet)
7. Must submit a one-page typed statement, with a minimum of one hundred words, from the applicant,
describing their character, personal interests and future plans (included in application).
8. All information must be completed in its entirety and submitted together by the deadline. Incomplete
submissions will be excluded from further review and deemed ineligible. Entries received after the
March 31, 2022 deadline will not be considered.
You have the option of submitting your completed Application, Academic transcript and ACT Scores
ONLINE or via MAIL.
ONLINE SUBMISSION:
- Name each file of your submission in the following manner:
*PastPres_Last Name_First Name_Application
*PastPres_Last Name_First Name_Transcript
*PastPres_Last Name_First Name_ACT_SAT_Scores
- example: PastPres_Johnson_Erica_Application
PastPres_Johnson_Erica_Transcript
PastPres_Johnson_Erica_ACT_Scores
- Use the following link to upload your submission files: https://bit.ly/3bkf2Km
MAIL SUBMISSION:
- Mail your submission to the following address:
2022 Education and Scholarship Committee
East St. Louis Alumnae Chapter, Delta Sigma Theta Sorority, Inc.
1012 S. 15th Street
East St. Louis, Illinois 62207
Proprietary to East St. Louis Alumnae Chapter
Delta Sigma Theta Sorority, Incorporated
2022 ESLAC Past Presidents Educational Book Scholarship Application
Page 3 of 7
Proprietary to East St. Louis Alumnae Chapter
Delta Sigma Theta Sorority, Incorporated
ESLAC Past Presidents Educational Book Scholarship Application
Personal Information
Name:
Last First Middle Initial
Date of Birth:_ / _/
Home Street Address
City
State Zip Code
Telephone #:
E-mail Address:
Parent / Guardian Name(s):
Academic Profile
High School:
Expected Graduation Date: Grade Point Average:
List Honors, Extracurricular Activities:
Colleges/University that you will attend
School City/State
Date Fall Classes Begin
2022 ESLAC Past Presidents Educational Book Scholarship Application
Page 4 of 7
Proprietary to East St. Louis Alumnae Chapter
Delta Sigma Theta Sorority, Incorporated
APPLICANT'S STATEMENT
1. Briefly tell us about yourself, including your education/career goals, and why you should be selected
for this scholarship? (Minimum 100 words required)
2022 ESLAC Past Presidents Educational Book Scholarship Application
Page 5 of 7
Proprietary to East St. Louis Alumnae Chapter
Delta Sigma Theta Sorority, Incorporated
APPLICANT'S CERTIFICATION STATEMENT
In submitting this application, I hereby certify that:
1. The following information is true and accurate to the best of my knowledge and that if selected, I must present
proof of enrollment in a college/university before I can receive the disbursement. Any information this is not
accurate and verifiable will disqualify me for consideration.
Print Applicant’s Name
Signature
Date
Print Parent/Guardian’s Name
Signature
Date
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signature
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signature
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2022 ESLAC Past Presidents Educational Book Scholarship Application
Page 6 of 7
Position: _
Contact Phone Number: _
Proprietary to East St. Louis Alumnae Chapter
Delta Sigma Theta Sorority, Incorporated
ESLAC Scholarship Reference / Recommendation Form #1
Name of applicant: _
Applicant Instruction: This form is to be provided to a teacher(s), minister, youth leader,
community service leader or employer who knows you well and who can speak to the attributes
listed below on your behalf in consideration for this award. Relatives cannot serve as
recommenders.
Recommender Instruction: Thank you for your assistance and for your willingness to
recommend the applicant listed above as we evaluate her for educational financial assistance.
Please attest to the following which will assist us in our selection process based on your
experience and knowledge of the applicant.
Please rate the applicant on the following characteristics, according to the scale listed from 1-5, 5
being the highest ranking. If you are unable to speak to a characteristic or skill, please note by circling
n/a.
▪ Demonstrated willingness to work
toward future goals
5
4
3
2
1
n/a
▪ Demonstrated sense of responsibility
5
4
3
2
1
n/a
▪ Enthusiasm for achieving success
5
4
3
2
1
n/a
▪ Honesty and integrity
5
4
3
2
1
n/a
▪ Ability to get along with others
5
4
3
2
1
n/a
▪ Emotional maturity
5
4
3
2
1
n/a
▪ Leadership skills
5
4
3
2
1
n/a
▪ Contributions to school
5
4
3
2
1
n/a
▪ Contributions to community
5
4
3
2
1
n/a
▪ Ability to succeed in chosen field
5
4
3
2
1
n/a
▪ Responsibility and care in completing
academic tasks
5
4
3
2
1
n/a
▪ Written and oral communication skills
5
4
3
2
1
n/a
Please print any additional comments in support of the applicant here:
Recommender’s Name: _
Recommender’s Signature: _ _ Date_
How long have you known the applicant? _ _ In what capacity? _
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signature
click to edit
2022 ESLAC Past Presidents Educational Book Scholarship Application
Page 7 of 7
Position: _
Contact Phone Number: _
Proprietary to East St. Louis Alumnae Chapter
Delta Sigma Theta Sorority, Incorporated
ESLAC Scholarship Reference / Recommendation Form #2
Name of applicant:
Applicant Instruction: This form is to be provided to a teacher(s), minister, youth leader,
community service leader or employer who knows you well and who can speak to the
attributes listed below on your behalf in consideration for this award. Relatives cannot serve
as recommenders.
Recommender Instruction: Thank you for your assistance and for your willingness to
recommend the applicant listed above as we evaluate her for educational financial assistance.
Please attest to the following which will assist us in our selection process based on your
experience and knowledge of the applicant.
Please rate the applicant on the following characteristics, according to the scale listed from 1-5, 5
being the highest ranking. If you are unable to speak to a characteristic or skill, please note by circling
n/a.
▪ Demonstrated willingness to work
toward future goals
5
4
3
2
1
n/a
▪ Demonstrated sense of responsibility
5
4
3
2
1
n/a
▪ Enthusiasm for achieving success
5
4
3
2
1
n/a
▪ Honesty and integrity
5
4
3
2
1
n/a
▪ Ability to get along with others
5
4
3
2
1
n/a
▪ Emotional maturity
5
4
3
2
1
n/a
▪ Leadership skills
5
4
3
2
1
n/a
▪ Contributions to school
5
4
3
2
1
n/a
▪ Contributions to community
5
4
3
2
1
n/a
▪ Ability to succeed in chosen field
5
4
3
2
1
n/a
▪ Responsibility and care in completing
academic tasks
5
4
3
2
1
n/a
▪ Written and oral communication skills
5
4
3
2
1
n/a
Please print any additional comments in support of the applicant here:
Recommender’s Name: _
Recommender’s Signature: _ _ Date _
How long have you known the applicant? _ In what capacity? _ _
click to sign
signature
click to edit
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East St. Louis Alumnae Chapter

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Completed 10 March 2022

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