TEST Scholarship Page - Alpha Chi Rho National Fraternity

Major Work mailing

Name

First

Last

Date of Birth

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email

Phone

Current College/University

Major

Graduation Month, Year

College/University Address

Address Line 1

Address Line 2

City

State

Zip Code

Other Address

Address Line 1

Address Line 2

City

State

Zip Code

Which is your mailing address?

Home
College
Other

AXP Chapter

(Please note in order to be considered for a scholarship, your National Initiation Fee must be paid).

Other Colleges/Universities Attended

Plans After Graduation

Essay

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In 500 words or less, tell us about yourself - What are your academic and career goals? Why do you deserve this scholarship? How will this scholarship help you? In addition to your personal background, tell the Scholarship Committee why you joined Alpha Chi Rho, how being a Brother of Alpha Chi Rho changed you, how you impacted the Fraternity (an individual Brother, your Chapter, or the Brotherhood at large) and how you plan on being involved with your Chapter and Brotherhood at large.

Chapter Involvement

List Officer Positions you have held in the Chapter - Recruitment Chair, Treasurer, Philanthropy Chair, etc.

School Related/Affiliated Activities

Please list activities which you have participated in at your Institution– student government, clubs, etc. Please also include how long you participated and any offices held.

Sports

Please list the sport(s) in which you have participated and how many years you participated.

Community Activities

Please list community activities in which you have participated without pay during college. Also include the type of work it was, what organization it was through, and the years participated without pay during college.

Work Experience

List jobs you have held in the past four years (Include your Title, Employer, Hours per week, Summer/School Terms).

Other Pertinent Information (Honors, Awards, etc.)

Assets (This helps us understand your financial situation. Estimate to the best of your ability)

Examples of Assets: Bank Accounts (checking/savings) – e.g., $1,200. Your car (if owned) – e.g., 2015 Toyota Corolla, approx. $6,000. Electronics – e.g., MacBook Air, $800. Investments – e.g., stocks, crypto, retirement. accounts.

Liabilities (This can include loans, credit card balances, or other debts. Estimates are fine)

Examples of Liabilities: Student Loans – e.g., $10,000. Credit Card Debt – e.g., $500. Car Loan – e.g., $4,000. Other personal loans or recurring debts.

Anticipated Income (Current Academic Year)

Include any income you expect to receive this year: jobs, internships, family support, or financial aid not already reflected above. (ex: Part time job = $4000, Family support = $2000, Work study = $1200)

Estimated Expenses

Include all major costs related to your education and living: tuition, rent, food, transportation, books, etc. (ex: Tuition = $12000, Books = $2000, Rent = $6000, Food $2400)

If your expenses exceed your income, how will you make up the difference?

Briefly explain how you plan to cover any gap — savings, family support, loans, etc. (ex: 'I will use savings and apply for student loans as needed')

Are you Interested in a Loan?

Are you related to any trustee or officer of the Foundation?

Amount of any previous loan from the Foundation

Date of any previous loan from the Foundation

Date loan is needed

Amount Requested

Parent Name

First

Last

Parent Phone

Parent Address

Address Line 1

Address Line 2

City

State

Zip Code

College transcript from the last semester:

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Reference letter from a faculty member, administrator, chapter advisor, or employer:

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