NORTH CAROLINA CENTRAL UNIVERSITY ALUMNI ASSOCIATION DISTRICT OF COLUMBIA CHAPTER. SCHOLARSHIP and FINANCIAL AID APPLICATION FORM

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1 NORTH CAROLINA CENTRAL UNIVERSITY ALUMNI ASSOCIATION DISTRICT OF COLUMBIA CHAPTER SCHOLARSHIP and FINANCIAL AID APPLICATION FORM _ Full Time Study /_/ _ Part-Time Study /_/ Semester Applying For: Fall 20 Spring 20 Summer 20 Please type or print. If you need additional space, please attach extra pages. ******************************************************************************* 1. Name SECTION A: STUDENT'S INFORMATION LAST FIRST MIDDLE MAIDEN 2. Social Security Number 3. Present Address Street Apartment # City State/County Zip Phone 4. Permanent Mailing Address Street Apartment # Phone City State/County Zip 5. U. S. Citizen /_/ yes /_/ no; If "no, citizenship and visa status 6. Sex (This is for reporting purposes only and does not affect applicant's eligibility) 7. Date of Birth / / Place of Birth month day year 8. Proposed field of Study

2 SECTION B: BIOGRAPHICAL INFORMATION HIGH SCHOOL EDUCATION 9. Name and Location of latest high school attended NAME LOCATION FROM TO Date of Graduation (or expected date) / / month day year Cumulative Class Rank ; Cumulative Grade Point Average 10. Please list below all awards, honors, scholarships, and other recognitions you have received. 11. List extra-curricular activities throughout your high school experience (additional sheets may be attached) 12. Essay questions: Please provide a one page response to the following (choose one): (High School applicants only) 1. What did you enjoy most from your high school experience? 2. How does community service benefit society? 3. What are your future aspirations and how do you foresee NCCU helping you to achieve those goals? * For scholarship consideration, skip to Section E. For financial aid consideration, go to Sections C through E)

3 UNDERGRADUATE EDUCATION (if applicable) 13. Have you attended more than one undergraduate institution? yes no If "yes, please complete the box below for each institution you have attended. On a separate sheet, please explain the reasons for your change of colleges. COLLEGE/UNIVERSITY LOCATION DATES OF ENROLLMENT BEGIN DATE END DATE 14. Awards and recognitions received from North Carolina Central University 15. Extra-curricular activities. List in order of their importance all significant college, community, or professional activities in which you have participated. Attach additional sheets, if necessary. 16. Applicant's cumulative grade point average at highest level of college work 17. Applicant's class rank

4 18. Essay questions: Please provide a one page response to the following (choose one): (Enrolled NCCU students only) 1. Describe how attending NCCU has inspired you to continue your pursuit for excellence. 2. What attributes do you exhibit on a daily basis that convince your peers to respect your ideals and opinions? 3. What are your ideas for motivating and increasing school spirit? ** If you are applying on the basis of scholarship, skip to Section E** **************************************************************************** SECTION C: HOUSEHOLD INFORMATION (Financial Aid applicants only) 19. PARENTS (for dependents) Parents' current marital status: _ /_/ Single /_/ Married /_/ Divorced /_/ Widowed /_/ Separated Parents' legal state of residence Total size of parents' household during semester applying for scholarship (Include student and all dependent persons) From the above number, how many persons will be in college and/or vocational schools during the period of time covered by this application? (Include the student who is applying and others who will be in college and/or vocational school at least halftime) 20. INDEPENDENT STUDENTS (no spouse) Total size of individual s household during semester applying for scholarship (Include student and all dependent persons) From the above number, how many persons will be in college and/or vocational schools during the period of time covered by this application? (Include the student who is applying and others who will be in college and/or vocational school at least half-time) 21. STUDENT (and spouse) Total size of student's household during semester applying for scholarship (Include student, spouse and student's dependent children) Total number in student's household that will be in college and/or vocational schools during the application time frame

5 ***************************************************************************** SECTION D: INCOME INFORMATION 22. Gross family income $ # of exemptions (parents) 23. Student (spouse) income $ # of exemptions 24. Approximate amount of debt $ 25. Other financial assistance (i.e. grants, loans, work aid) being received and/or promised to you (Please specify type of assistance, dollar amount and the duration of assistance, be it monthly, by semester, annually, etc.) ****This is a mandatory field and the information must be provided to the scholarship committee, to the applicant s best knowledge, for consideration. You will be called prior to funds forwarded to NCCU.**** **************************************************************************** SECTION E: MISCELLANEOUS INFORMATION 1. Attach three letters of recommendation with this application. If you know a financial member from the DC Chapter, his or her recommendation counts for one of the letters. Consideration will be given to all applicants. **************************************************************************** Any additional comments you might wish to make will be appreciated. I certify that the information provided in this application is accurate to the best of my knowledge, and I understand that no part of this application will be used for any purposes other than those required for the determination of my scholarship or financial aid eligibility. SIGNATURE OF APPLICANT

6 SIGNATURE OF PARENT OR GUARDIAN (required for applicants under 18 years of age) DATE ************************************************************************ In agreement with the purposes stated above, I hereby authorize the release of information from the Admissions Office, Registrar's Office, The Financial Aid Office or other university agencies, to the District of Columbia Chapter, North Carolina Central University. SIGNATURE OF APPLICANT SIGNATURE OF PARENT OR GUARDIAN (required for applicants under 18 years of age) DATE

7 NORTH CAROLINA CENTRAL UNIVERSITY ALUMNI ASSOCIATION DISTRICT OF COLUMBIA CHAPTER SCHOLARSHIP/FINANCIAL AID PROGRAM The District of Columbia (DC) Chapter of the North Carolina Central University (NCCU) Alumni Association offers scholarships/financial aid each year to students from the metropolitan DC area accepted to North Carolina Central University. The awards vary in amount and are renewable for a maximum of four (4) years. Prospective scholarship recipients are those applicants who have: 1) demonstrated academic achievement (GPA of 3.0 or better); 2) participated in community service projects; and 3) engaged in extracurricular activities. Prospective financial aid recipients are those applicants who have: 1) demonstrated collegiate academic abilities (GPA of 2.5 or better); 2) participated in community service projects; 3) engaged in extracurricular activities; and 4) met our financial need guidelines (copy attached). APPLICATION PROCEDURES 1. Complete all applicable items on the application form. 2. Return all necessary information to: District of Columbia Chapter NCCU Alumni Association Attn: Scholarship/Financial Aid Committee Post Office Box 1508 Washington, DC The deadline for receiving all fall applications is June 1. The deadline for spring applications is January 3 and the deadline for summer applications is April 5 (if money is available). We will accept a postmarked date or submission of the deadlines listed above. All scholarship/financial aid recipients for the fall semester will be notified no later than July 31. For the spring semester, recipients will be notified no later than January 15. For the summer session, recipients will be notified no later than May 15.

8 NORTH CAROLINA CENTRAL UNIVERSITY ALUMNI ASSOCIATION DISTRICT OF COLUMBIA CHAPTER SCHOLARSHIP/FINANCIAL AID PROGRAM The District of Columbia Chapter of NCCU Alumni Association offers a limited number of scholarships and financial aid awards to students enrolled and/or accepted for enrollment at North Carolina Central University. Program Guidelines A. Applicants for scholarships/financial aid must be enrolled or accepted for enrollment at North Carolina Central University. B. Applicants must be a resident of the metropolitan D. C. area, (the city of D.C., MD counties of Prince George s, Montgomery, Anne Arundel, Calvert, Charles, St. Mary s, Frederick and Howard, and VA cities of Alexandria, Falls Church, Fairfax City and counties of Arlington, Fairfax, Loudon, Prince William and Stafford) and show evidence of participation in community service activities. C. The D.C. Chapter scholarship will be a four-year renewal program subject to availability of funds. Scholarship renewal will be based on full-time recipients G.P.A. of 3.0 or above. Consideration will be given to applicants' special talents in such areas as music, drama, art, etc., as well as involvement in extracurricular, community and other activities. D. The D.C. Chapter financial aid program is designed to provide financial support to students who demonstrate a dire need to obtain financial assistance to remain in school. Applicants are asked to express their financial need in a one page essay. E. Applicants must submit to the Scholarship/Financial Aid Committee a completed Scholarship and Financial Aid Application package, including appropriate signature(s) in the space provided, to: District of Columbia Chapter NCCU Alumni Association Attn: Scholarship/Financial Aid Committee Post Office Box 1508 Washington, DC F. All applications must be supported by recommendations from three individuals from three different aspects of your environment (i.e. school, community leaders, church, employment, etc.). It is highly recommended that one of those individuals be a financial alumnus of the District of Columbia Chapter or the National Alumni

9 Association of North Carolina Central University. However, if you do not know anyone from the chapter or NCCU alumni association, your package will still be considered for receiving financial assistance. G. Applicants from all classifications, including graduate and professional students, may apply. H. Graduate and professional students at NCCU in part-time or full-time programs from the metro D.C. area will be considered for the chapter's Scholarship/Financial Aid program. I. Incoming freshmen accepted at North Carolina Central University from high school must have graduated in the upper third of his or her class or with a minimum 2.5 cumulative grade point average or higher. J. Upper class persons must have at least a 3.0 cumulative grade point average for scholarship consideration. K. Upper class persons must have at least a 2.5 cumulative grade point average for financial aid consideration. L. Members of the Scholarship/Financial Aid Committee will review all application materials (academic record, application form, and recommendations). This committee is the body that will select students to receive scholarships/financial aid and determine the amount to be awarded to each. M. All scholarship/financial aid awards for the fall semester shall be made by July 31st. All scholarship/financial aid money to be awarded for the spring semester shall be awarded to recipients by January 15 th and by May 15 th for the summer session (if funds are available). N. All awards will be forwarded to the NCCU Comptroller s Office and a copy of the check and recipient names will be sent to the Office of Alumni Relations and Annual Fund. O. Applicants selected to receive scholarships/financial aid will be notified by mail of the amount of the award, including procedures for utilizing the award.

10 NORTH CAROLINA CENTRAL UNIVERSITY ALUMNI ASSOCIATION DISTRICT OF COLUMBIA CHAPTER SCHOLARSHIP/FINANCIAL AID PROGRAM Recommendation Form Mr./Ms./Miss has applied for financial assistance from the Scholarship/Financial Aid program of the District of Columbia Chapter of North Carolina Central University Alumni Association. He/She has considered you as a reference. The Scholarship and Financial Aid Committee would be pleased to receive your written recommendation, including the number of years you have known the applicant, in what capacity, your assessment of the applicant's personal character and/or academic potential and an evaluation of his/her leadership qualities. Please use this form in writing your recommendation. If additional space is required, use the back of this form. Return your recommendation by June 1 to: District of Columbia Chapter NCCU Alumni Association Attn: Scholarship/Financial Aid Committee Post Office Box 1508 Washington, DC 20013

11 Name Title/Position Alumnus of NCCU? Yes No Class of Member of Alumni Chapter or National member (check if applicable) Signature Date