Twin City Alumni Chapter Scholarship Application. The above information can be delivered or mailed to either of the following addresses:

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1 Twin City Alumni Chapter Scholarship Application Enclosed are copies of the information concerning the amount of the scholarship, criteria, general procedures for applicants, and procedures for payment. If the student meets the criteria outlined, applicants for the scholarship must provide the following: I. Entering Freshman A. Completed Application B. Three references (two from high school instructors and one from a member in the community). C. Official copy of high school transcript which indicates grade point average and SAT score. D. Copy of Acceptance Letter from NC A&T State University. II. Transfer Students A. Completed Application B. Official copy of transcript from school your transferring from which indicates grade point average. C. Copy of Acceptance Letter from NC A&T State University. III. Continuing Students (Second Semester Freshman, Sophomore, Juniors, and Seniors) A. Submit a letter applying for the scholarship. B. Submit a certified copy of NC A&T transcript. The above information can be delivered or mailed to either of the following addresses: Twin City Alumni Chapter Post Office Box 781 Winston-Salem, NC Velma J. Simmons, Chairperson Twin City Alumni Chapter Scholarship Committee Simmons Tax, Accounting & Financial Management Services 544 N. Graham Avenue Winston-Salem, NC Velma J. Simmons, Chairperson Twin City Alumni Chapter Scholarship Committee 5325 Camp Betty Hastings Road Walkerton, NC 27051

2 The deadline for submitting Scholarship Applications are as follows: 1. Spring Semester December Fall Semester June 30 If you have any questions, please contact me at my office at (336) or at home at (336) Sincerely, Velma J. Simmons, Chairperson Twin City Alumni Chapter

3 TWIN CITY ALUMNI CHAPTER SCHOLARSHIP NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY ALUMNI ASSOCIATION THE TWIN CITY ALUMNI CHAPTER of the North Carolina Agricultural and Technical State University Alumni Association established a scholarship program in 1986 for students attending North Carolina Agricultural and Technical State University which is administered by the North Carolina Agricultural and Technical State University Alumni Association. The Scholarship is known as THE TWIN CITY ALUMNI CHAPTER SCHOLARSHIP and the recipient(s) are known as THE TWIN CITY ALUMNI CHAPTER SCHOLARS. To maintain this scholarship program, the TWIN CITY ALUMNI CHAPTER, MEMBERS, AND SUPPORTERS shall send contributions to the North Carolina Agricultural and Technical State University Alumni Association designated for the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP. The first TWIN CITY ALUMNI CHAPTER SCHOLARS were chosen for the 1986 Fall Semester. Thereafter, additional scholars have been chosen annually or biannually as determined by the TWIN CITY ALUMNI CHAPTER. The TWIN CITY ALUMNI CHAPTER maintains the privilege of restricting the scholarship(s) to the residents of the local boundaries (Winston-Salem/Forsyth County) of the members of the TWIN CITY ALUMNI CHAPTER. AMOUNT OF SCHOLARSHIP The amount of the scholarship, awarded to an enrolled full-time student of North Carolina Agricultural and Technical State University and selected by the TWIN CITY ALUMNI CHAPTER, shall not be more than $ per semester. `The amount of the scholarship for a student enrolled less than full-time, but at least twelve (12) semester hours, shall not be more than $ per semester. The scholarship award may be made in either the Fall or Spring Semester, or both of the academic year of eligibility. CRITERIA 1. The Scholarship shall be limited to students who are citizens of the United States, leave in Winston- Salem/Forsyth County, and shall be based on academic achievement and financial need. 2. The recipient must have graduated from an accredited high school or will be graduated from such school prior to enrollment date of the Fall or Spring Semester of the year for which selection is made. 3. The recipient must have completed an academic high school grade point average of B or better. 4. The recipient must have scored 700 or higher on the Scholastic Aptitude Test (SAT) or a comparable score or higher on the Admission College Test (ACT). 5. Those students who exhibit financial need and meet all the above criteria shall be given priority consideration. 6. Provide evidence of acceptance by North Carolina Agricultural and Technical State University as a student.

4 PROCEDURES FOR ENTERING FRESHMEN APPLICANTS Applicants who wish to be considered for the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP must comply with the following procedures: 1. Apply to North Carolina Agricultural and Technical State University for admission. 2. Apply to the Twin City Alumni Chapter for the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP by completing the application for the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP. 3. Submit three (3) letters from references with APPLICATION (two letters from high school instructors and one from a member of the community). 4. Official copy of high school transcript which indicates grade point average and SAT score. 5. Provide evidence of acceptance by North Carolina Agricultural and Technical State University as a student. PROCEDURES FOR TRANSFER STUDENT APPLICANTS Applicants who wish to be considered for the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP as a transfer student must comply with the following procedures: 1. Apply to North Carolina Agricultural and Technical State University for admission. 2. Apply to the Twin City Alumni Chapter for the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP by completing the application for the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP. 3. Official copy of transcript from school your transferring from which indicates grade point average. 4. Provide evidence of acceptance by North Carolina Agricultural and Technical State University as a student. PROCEDURES FOR ADVANCED STUDENT APPLICANTS The TWIN CITY ALUMNI CHAPTER commits itself to a one-semester agreement only with the chosen recipients(s). Additional Scholarships may be awarded to advanced students who apply by sending a letter (along with a copy of the grade transcript) requesting the scholarship. Under the following conditions, advanced students may be considered for a TWIN CITY ALUMNI CHAPTER SCHOLARSHIP (if qualified applicants are not chosen from entering freshmen class): 1. Second semester Freshmen must have earned a B or better grade point average at the end of the first semester. 2. Advanced students (sophomores, Juniors, and Seniors) must have maintained a B or better grade point average at the end of each semester. 3. Those students who exhibit financial need and meet the criteria listed in (1) or (2) above shall be given priority consideration.

5 PROCEDURES FOR SELECTION OF RECIPIENTS The TWIN CITY ALUMNI CHAPTER SCHOLARSHIP COMMITTEE shall have the responsibility for the final selection of recipients within the eligibility and criteria guidelines contained in this agreement. 1. Alumni, who are financial members of the TWIN CITY ALUMNI CHAPTER, may recommend persons to the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP COMMITTEE for consideration as TWIN CITY ALUMNI CHAPTER SCHOLAR(S). The person(s) making the recommendation will be responsible for assisting in the obtaining of proper documentation for the applicants. 2. After receipt of the APPLICATIONS (with three references), the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP COMMITTEE will screen those students applying for the scholarship. 3. The TWIN CITY ALUMNI CHAPTER SCHOLARSHIP COMMITTEE, during the regular monthly meeting of the TWIN CITY ALUMNI CHAPTER, will present its selection of percipients for approval by the members of the CHAPTER. PROCEDURES FOR PAYMENT 1. The TWIN CITY ALUMNI CHAPTER, MEMBERS, AND SUPPORTERS shall send contributions to the North Carolina Agricultural and Technical State University Alumni Association designated for the TWIN CITY ALUMNI CHAPTER SCHOLARSHIP. 2. The TWIN CITY ALUMNI CHAPTER shall notify the University and the Alumni Association of the name of each recipient and the amount of the scholarship. 3. The University, through it s Office of Student Financial Assistance, will send a statement of billing to the Executive Director of the Alumni Association. Such billing will be for the amount designated by the TWIN CITY ALUMNI CHAPTER for the semester of eligibility and shall be paid by the Alumni Association to the University.

6 NORTH CAROLINA AGRICULTURAL AND TECHNICAL STATE UNIVERSITY ALUMNI ASSOCIATION APPLICATION FOR TWIN CITY CHAPTER ALUMNI SCHOLARSHIP Please answer all questions making entries legible (with black ink). Return the completed application to the Twin City Alumni Chapter, ATTN: Twin City Alumni Scholarship Committee, Post Office Box 781, Winston-Salem, North Carolina I am voluntarily providing on this form my social security number with the understanding that it will be used only as a personal identifier for the internal record keeping and data processing Social Security Number operations of the Twin City Chapter Alumni Association. DATE OF COUNTY OF RESIDENCE APPLICATION COMPLETE LEGAL NAME Last First Middle Initial CURRENT ADDRESS Number and Street Apt. # City/Town State or County Zip Code Area Code and Home Phone Area Code and Work Phone Parent(s) Name: Last First Middle Address Number & Street City/Town Zip Code Area Code and Home Phone Area Code and Work Phone ARE YOU A CITIZEN OF YES SEX MALE DATE OF BIRTH THE UNITED STATES? NO FEMALE Mo. Day Year High School From which you will (or have) graduate(d): INTENDED TERM OR ENTRY: FALL 20 SPRING 20 MAJOR: HAVE YOU PREVIOUSLY HAVE YOU EVER ENROLLED APPLIED TO A&T? YES (Yr.) NO IN CLASSES AT A&T? YES (Yr.) NO PLEASE INDICATE ANY OTHER COLLEGES/UNIVERSITIES TO WHICH YOU HAVE APPLIED, OR INTEND TO APPLY: HOW DID YOU FIRST LEARN OF A&T STATE UNIVERSITY? PLEASE LIST THE NAMES OF MEMBERS OF YOUR FAMILY WHO HAVE GRADUATED FROM A&T HONORS AND AWARDS [ ] Class Officer [ ] Governor s School [ ] Who s Who [ ] National Honor Society (Check each that applies) [ ] NMSQT Finalist/semifinalist [ ] Girls or Boys State ATHLETICS (List): OTHER SPECIAL TALENTS (List):

7 Please submit the following with your application: Three References: Two from your high school instructors and one from a member of the community. RELEASE OF ACADEMIC DATA FOR SCHOLARSHIP CONSIDERATION The undersigned student consents to his/her consideration for the following scholarship(s) at North Carolina Agricultural and Technical State University: TWIN CITY CHAPTER ALUMNI SCHOLARSHIP. The student further consents to the release of academic data from his/her student file to the benefactors of this scholarship for their consideration in connection with the awarding of said scholarship. Data to be released may include the high school record, admission test scores and subsequent semester grade point average accumulated at North Carolina Agricultural and Technical State University. This authorization extends to any and all semesters in which the student receives the scholarship noted above. Student Parent or Guardian (if student is not 18 years or age) By signing this application, I agree to abide by the policies and regulation of Agricultural and Technical State University and to the best of my knowledge, the information I have given is true. I understand that any misrepresentation of facts on this application will be cause for refusal of the Twin City Alumni Scholarship. Signature: Signature: (Parent/Guardian if applicant is under 18) Date: