1. NAME _________________________________________________________________________
2. PRESENT ADDRESS _____________________________________________________________
3. PHONE NUMBER _______________________________________________________________
4. PERMANENT ADDRESS _________________________________________________________
5. PHONE NUMBER _______________________________________________________________
6. SOCIAL SECURITY NUMBER _____________________________________________________
7. COLLEGE/UNIVERSITY __________________________________________________________
8. DES CHAPTER _________________________________________________________________
9. CHAPTER ADVISOR _____________________________________________________________
10. GRADUATION DATE ____________________________________________________________
11. CURRENT CUMULATIVE GPA _____________________________________________________
12. MAJOR _______________________________________________________________________
13. DEGREE SOUGHT ______________________________________________________________
14. HONORS AND AWARDS__________________________________________________________ ________________________________________________________________________________
________________________________________________________________________________
15. LEADERSHIP AND SERVICE ACTIVITIES _____________________________________________ ________________________________________________________________________________
________________________________________________________________________________
16. EXPLAIN ANY CIRCUMSTANCES THAT MAY BE HELPFUL IN ASSESSING YOUR NEED FOR
FINANCIAL ASSISTANCE _____________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ __________________________________________________________________________________
17. IN A ONE-TWO PAGE ESSAY DESCRIBE WHAT PARTICULARLY QUALIFIES YOU FOR A DES SCHOLARSHIP