0102 Lee Building

College Park, Maryland 20742

TEL: 301-314-9000 & 888.313.2404

TTY: 301-314-7017 FAX: 301-314-9587

http://www.financialaid.umd.edu

OFFICE OF STUDENT FINANCIAL AID

Application for the Alpha Chi Sigma Books to Succeed Scholarship

Office of Student Financial Aid

Check one: __2010-11 __2011-12 __2012-13 __2013-14 __2014-2015 __2015-16

The Alpha Rho chapter of Alpha Chi Sigma established the Alpha Chi Sigma Books to Succeed Scholarship to help provide financial support to college students who are in need of funding for books.

To become eligible for the Alpha Chi Sigma Books to Succeed Scholarship applicants must:

v Be majoring in Chemistry or Biochemistry

v Demonstrate financial need as determined by the Office of Student Financial Aid

v Maintain good academic standing (2.50 GPA and above)

v Be a full-time undergraduate student (12 credits)

All scholarship applications must be completed and received by the Office of Student Financial Aid no later than Friday, December 9, 2011. The Alpha Chi Sigma Books to Succeed Scholarship committee will then review all applications and mail scholarship award notifications to the final recipient(s). Students who are selected to receive the Alpha Chi Sigma Books to Succeed scholarship will receive book funding that is based on the University approved cost of attendance for the Spring 2012 semester.

Should you have any questions regarding this application feel free to email

Name ____________________________________________________

University ID Number_______________________________________

Address___________________________________________________

City_________________________ State___________ Zip______

Email________________________ Cumulative GPA __________

I hereby authorize the release of information related to my qualifications for this award between the Office of Student Financial Aid and the Scholarship Donor. This information may include full name, address, GPA (high school and college), SAT and scores, extracurricular and community involvement activities.

Student Signature Date

(Turn Over)

To apply for the Books to Succeed Scholarship complete the following:

¨ Attach a resume or list of your participation in community service and extracurricular activities

Essay Question

¨ If you had to write an essay what would you write it about and why?