The Charles Drew Memorial Scholarship Fund, Inc.
Gamma Pi Chapter
Omega Psi Phi Fraternity, Inc.
Post Office Box 4072
Capitol Heights, Maryland 20791-4432
Continuing Student
Scholarship Application
All fields must be completed in order to be eligible:
1. Name: ______
Last First Middle Telephone Number
2. Address: ______
Street
______
City State Zip
3. Date of Birth: ______Sex: Male ______Female ______Email: ______
4. Name of the university you attend now: ______
5. Parents/Guardians: Father ______
Mother ______
Guardian ______
6. Address of parents or guardian: ______
______
7. High School you graduated from: ______
8. Cumulative Grade Point Average: (Please include an official transcript) ______
9. Have you served as a volunteer, tutor, mentor, peer mediator, or advisor while at college? If so, please explain.
10. List extracurricular/community activities in which you participate in while at college:
______
______
______
11. List offices held and honors received:
______
______
______
______
12. How important is it for you to become a leader and/or a role model? How are you currently displaying these characteristics?
13. Please attach two (2) written letters of recommendation from current teachers, counselors, or community activity coordinators/leaders.
Certification and Authorization. I hereby certify that the information provided to complete this application is true and correct and authorize the use of the photograph submitted with this application by The Charles Drew Memorial Scholarship Fund, Inc. and Gamma Pi Chapter in promoting the Scholarship Program.
14. Date: ______Signature of Applicant: ______
All materials must be received or post marked no later than midnight, June 30, 2017.
**Note: Continuing Student Scholarship Program. If you received the Charles Drew Memorial Scholarship Fund, Inc. scholarship or Book Award recipients, you will be eligible to apply for a continuing student scholarship during your subsequent years in college. These scholarships will be awarded on a competitive basis if you maintain satisfactory academic progress (3.0 grade point average and in good standing with your institution) towards your degree. Please provide your latest contact information to the Charles Drew Memorial Scholarship Fund, Inc. so that you can receive continuing student information and applications.
Submit all materials to:
The Charles Drew Memorial Scholarship Fund, Inc.
Gamma Pi Chapter, Omega Psi Phi Fraternity, Inc.
Post Office Box 4072
Capitol Heights, MD 20791-4432
Recipients and/or their representative(s) will be recognized at the Gamma Pi Chapter Achievement Week celebration in November 2017.
For information on the Charles Drew Memorial Scholarship Fund, Inc., please visit the web site at www.charlesdrewmsf.org.
CDMSF Form Revised 05/17 Page 1