Counselor Nomination Form

Alpha Phi Alpha Fraternity, Incorporated

Tau Lambda Chapter Education Foundation

P.O. Box 281033
Nashville, Tennessee 37228

2017-2018 Education Foundation Scholarships

Students, Parents, Educators, and Community Leaders:

Alpha Phi Alpha Fraternity, Incorporated was founded at Cornell University in Ithaca, NY, on December 4, 1906. It was the first Greek letter fraternity in America for African-American men. The objectives of the fraternity are to stimulate the ambition of its members; to prepare its members for the greatest usefulness in the causes of humanity, freedom, and dignity of the individual; to encourage the highest and noblest form of manhood; and to aid down-trodden humanity in its efforts to achieve higher social, economic and intellectual status.

Tau Lambda Chapter of Alpha Phi Alpha Fraternity, Inc. is a graduate chapter established in Nashville, TN, in1926. Tau Lambda supports and participates in many community programs and civic activities including the UNCF, March of Dimes, Big Brothers/Big Sisters and the Boy Scouts of America. The Tau Lambda Education Foundation was established in 1978, as a 501c(3) tax exempt foundation which functions apart from the Fraternity. Its purpose is to provide a fund for the promotion and financial support of scholarship, civic responsibility, and social adjustment among young men and women from middle school through college.

The Tau Lambda Chapter of Alpha Phi Alpha Fraternity, Inc. is accepting applications for scholarship funds awarded by the Education Foundation. The Foundation provides financial assistance to African-American high school males who have demonstrated academic promise and financial need, and will pursue post-secondary education at an accredited college/university in the United States. Since its inception, the Foundation has awarded scholarships, based on merit and financial need to deserving students, and engaged in a broad range of community service programs aimed at exemplary character and leadership. Two distinct scholarship awards are offered: The Mack C. Jolley Service Scholarship and The Tau Lambda Education Foundation Achievement Scholarship. Award recipients will be selected from the pool of applicants received by the designated deadline of February 1, 2018.

Please review and share the enclosed scholarship application, timeline, reference forms and essay topics with students who meet the criteria. Candidates may only select ONE scholarship category to apply for and complete the appropriate essay topic for the respective scholarship chosen. If you have additional questions, please contact Terrance J. Gibson, Chairman at (615)308-5978 or email at .

MACK C. JOLLEY SCHOLARSHIP

The Foundation is seeking applicants for the Mack C. Jolley Service Scholarship. This scholarship honors the memory of Brother Mack C. Jolley who was a tireless servant to community causes and supporting the elderly. The recipient receives a one-time award of $1,000. The student must have minimum of 2.5 cumulative grade point average. An official transcript must be submitted to the Scholarship Committee for review for the scholarship to be awarded.

A nominee must demonstrate proven leadership ability, involvement in extracurricular activities, exemplary moral character and high scholastic aptitude. The student must be recommended by the senior counselor and an academic teacher.

Scholarship award recipients will be invited and asked to speak during annual Tau Lambda Scholarship events held each year. Applications must be post marked by February 1 of the current academic year. Due to the volume of applications you are invited to submit one nomination.

Scholarship Criteria:

The applicant should be:

· An African American male

· At least 17 years of age at the time of application

· A citizen or permanent resident of the U.S.

· Beginning full-time study at an accredited post-secondary institution in the U.S. in the fall of the year the award is presented.

The applicant should demonstrate:

· Academic excellence with a 2.5 grade point average or higher

· Leadership in extracurricular activities

· Community involvement

· Financial need

The applicant should provide (please send all the documents in one package):

o Completed application

o Official high school transcript

o Two letters of recommendation: 1) high school counselor; 2) high school teacher. Recommendations must arrive in a sealed envelope with the signature of the reference on the back of the envelope.

o Permission and Liability Waiver

o Essay: “The Benefits of a Quality Education” (no more than 300 words) signed by the applicant in the bottom right corner.

The scholarship must be used for a full-time course of study at an accredited college or university, starting in the fall of the year the award is presented. Funds will be paid directly to the recipients’ college or university, and will not be applied toward correspondence courses, internet courses, or study in a country other than the U.S.

Education Foundation Achievement Scholarship

The Education Foundation Achievement Scholarship is a 4-year renewable award of $1,000 for four (4) consecutive years for a total of $4000. Continuation is contingent upon the student achieving a minimum 3.0 cumulative grade point average at the end of each academic year. An official transcript must be submitted annually to the chairman of the Scholarship Committee for review for the scholarship to be renewed.

A nominee must demonstrate high scholastic aptitude, proven leadership ability and involvement in extracurricular activities and exemplary character. The student must be nominated by a school counselor and an academic teacher.

Scholarship Criteria:

The applicant should be:

· An African American male

· At least 17 years of age at the time of application

· A citizen or permanent resident of the U.S.

· Beginning full-time study at an accredited post-secondary institution in the U.S. in the fall of the year the award is presented.

The applicant should demonstrate:

· Academic excellence with a 3.0 grade point average or higher

· Leadership in extracurricular activities

· Community involvement

· Financial need

The applicant should provide (please send all the documents in one package):

o Completed application

o Official high school transcript

o Two letters of recommendation: 1) high school counselor; 2) high school teacher. Recommendations must arrive in a sealed envelope with the signature of the reference on the back of the envelope.

o Permission and Liability Waiver

o Essay: “The Benefits of a Quality Education” (no more than 300 words) signed by the applicant in the bottom right corner.

Scholarship Application

Please indicate which scholarship you are applying for:

Mack C. Jolley [ ] The Education Foundation [ ]

Applicant Biographical Information:

Name ______

First Middle Last

Permanent Address ______

______

(City) (State) (Zip)

Home Ph: ( ) ______

Cell Ph:( )______

Email: ______

Date of Birth: ______Last 4 digits of SSN# ______

Parent/Guardian of applicant: ______

Number of children in the household, including applicant _____ (Ages) ______

How many will be in college this fall? ______

Financial Need:

Annual household income $______

Do you expect parental contribution toward college expenses? Yes [ ] No [ ]

If not, who will be responsible for your expenses? ______

Have you received other scholarships or grants? Yes [ ] No [ ]

Academic Profile (Transcript required):

High School ______

GPA: ______/4.0 scale (Request an official transcript from your school counselor)

ACT Score (if applicable):______SAT Score (if applicable):______

Demonstrated Leadership:

(Use additional sheets to list organizations, offices held, community involvement, etc.)

Extracurricular activities: ______

Awards/Honors: ______

(Use additional sheets to list your academic honors, achievements, etc.)

Community Activities: ______

Have you ever been subject to disciplinary action (i.e. suspended)? Yes [ ] No [ ]

If yes, please explain.______

College/University you plan to attend:______

Are you expecting to receive other scholarships or grants? Yes [ ] No [ ]

If yes, list type(s) and amount(s) expected to receive: ______

Recommendations:

(Use the attached recommendation forms. Obtain letters from a school counselor and teacher who have taught the applicant within the past 3 years.)

Recommendations will be provided by:

Teacher:______/School:______

Counselor:______/School:______

NOTE: Application and support documents must be postmarked by February 1.

Mail to: Tau Lambda Education Foundation

ATTN: Terrance J. Gibson

Scholarship Committee

2073 Sherbrooke Lane

Nashville, TN 37211

(615) 308-5978

Only selected applicants will be notified to interview by the Scholarship Committee.

[Tau Lambda Scholarship Committee reserves the right to verify the accuracy of the information contained in the application packet. All information will be kept confidential.]

Scholarship Award Information

· Must be a full-time student at an accredited college/university, starting fall 2018.

· Will be paid directly to the recipient’s college/university.

· Will not pay for study outside of the United States.

______

Applicant’s Signature Date

MACK C. JOLLEY SCHOLARSHIP ESSAY

The Role of Community Service and Civic Responsibility

The MACK JOLLEY scholarship promotes education to encourage civic responsibility, service and to strengthen academic achievement. Explain how this goal will be promoted if you are a recipient of the scholarship. Please include what you aspire to contribute to your community and society as a whole; include what your passions are. With these themes in mind, use 300 words or less to share how a college education will impact you.

Education Foundation Achievement Scholarship Essay

The Benefits of a Quality Education

This scholarship promotes education to encourage leadership and to strengthen academic achievement. Explain how this goal will be promoted if you are a recipient of the scholarship. Please include what you aspire to and what your passions are. With these themes in mind, use 300 words or less to share how a college education will impact you.

Teacher Nomination Form

APPLICANT: After filling in your name, give the form to a teacher (must have taught you within past 3 years) to complete and return to you in a sealed envelope, with the signature of the reference on the back.

Student Name: ______

TEACHER: Please tell us to what extent the applicant has demonstrated full use of their intellectual potential. How would you describe the applicant’s values and character? Are there other factors which may be relevant?

______

Teacher’s Signature Date

School Counselor Nomination Form

APPLICANT: After filling in your name, give the form to your school counselor to complete and return to you in a sealed envelope, with the signature of the reference on the back.

Student Name: ______

School Counselor Name:______

School Counselor: Please tell us to what extent the applicant has demonstrated full use of their intellectual potential. How would you describe the applicant’s character?
(Please attach a copy of the applicant’s transcript)

______

Counselor’s Signature Date

(Please attach a copy of the applicant’s transcript)

P.O. Box 281033
Nashville, Tennessee 37228

Permission and Liability Waiver for Scholarship Recipients/Applicants

I ______grant permission for my likeness, (PRINT STUDENT NAME)
in all forms, to be used in all media, including but not limited to photographic images and video on Tau Lambda Education Foundation promotional materials. Such promotional materials may include, but not be limited to: Website, Brochures, E-Newsletters and print mediums. I expect absolutely no compensation for the use of my likeness in these promotional materials.

Irelease all claims for copyright or ownership. Furthermore, I authorize the Tau Lambda Educational Foundation to use my likeness, in all forms, including but not limited to name, voice, image, and biography for publicity or promotion without any compensation or payment being made for any such use or further use thereof on an unlimited basis in all markets and in all media now known or hereafter created.

I have read the release and waiver of liability and fully understand its consent. I voluntarily agree to the terms and conditions stated above.

______
(Student Signature) (Date)

If Participant is Under 18 (must be at least 17 years of age):
I, ______as legal guardian of______,
(print guardian name) (print student name)

consent to the above listed terms and conditions.

Parent/Guardian Signature: ______Date: ______

“Manly Deeds, Scholarship and Love for all Mankind”