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TEST Scholarship Page
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Personal Info
-
Step
1
of 8
Name
*
First
Last
Date of Birth
*
Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
*
Phone
*
Next
Current College/University
*
Major
*
Graduation Month, Year
*
College/University Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Other Address
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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
*
Next
Essay
*
Click or drag a file to this area to upload.
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.
Next
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.)
Next
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')
Next
Are you Interested in a Loan?
*
Select
Yes
No
Are you related to any trustee or officer of the Foundation?
*
Select
Yes
No
Amount of any previous loan from the Foundation
Date of any previous loan from the Foundation
Date loan is needed
Amount Requested
Next
Parent Name
*
First
Last
debts. Estimates Information
Parent Phone
Parent Address
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Next
College transcript from the last semester:
*
Click or drag a file to this area to upload.
Reference letter from a faculty member, administrator, chapter advisor, or employer:
*
Click or drag a file to this area to upload.
Previous
Submit
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