Fortgang KDP Chapter Service Scholarship
Application Form
Spring 2017
The Executive Council and General membership of UNI’s Psi Chapter of Kappa Delta Pi are happy to announce the thirty-seventh awarding of our Stephen J. Fortgang – KDP Chapter Service Scholarship. The scholarship was initiated in 1990 by a group of alumni and current members.Additional funds have been contributed and this semester the chapter will offer a $1000 award to one of our members!
This scholarship is designed to honor Psi Chapter Kappa Delta Pi members who best exhibit the ideals of Fidelity to Humanity, Science, Service, and Toil to which we are all pledged. It is expected that candidates will have begun to demonstrate their commitment to these ideals through participation in the educational and service projects for which the Psi Chapter is known. Both officers and other members are welcome to apply. To be eligible, candidates must have at least one full time semester remaining at UNI before graduation. Candidates must be active (meaning current dues paid by 09/14/16) and a demonstrated record of service to the chapter. Spring 2017 initiates are NOT eligible. The selection committee will be comprised entirely of chapter alumni members.
We also strongly encourage you to complete the UNI Scholarship Application form online and to check the KDP box under activities, but that is not required for this award.
APPLICATION FORM
Personal Statement
Name ______Student Number ______Expected Semester of Graduation ______
Campus Address ______Telephone ______
Permanent Address ______
______
Permanent Telephone ______Campus E-mail ______
Expected Semester of Student Teaching ______
Major: ______Minor: ______
Overall GPA ______GPA in Major ______
Other Post Secondary Schools (Including Community Colleges) Attended ______
Names of student organizations of which you are a member ______
______
< Over >
Fortgang KDP Chapter Service Scholarship / Page 2Non-Kappa Delta Pi voluntary (not for class) educational or service activities at UNI ______
______
Academic honors received while at UNI ______
______
Work Experiences (including voluntary) related to education ______
______
Semester of initiation into Kappa Delta Pi ______
Did you attend?Yes No
If more than a year has passed, have you renewed your membership?
Yes No Does not apply
Names of Psi Chapter Activities in which you have participated and Offices held: ______
______
______
Approximate number of Psi Chapter membership meetings attended ______
Other UNI KDP involvements not mentioned above ______
______
Please attach a personal statement of approximately one (but not more than two) typewritten, single-spaced pages, in which you express your reasons for feeling that you are qualified to receive the Fortgang – KDP Chapter Service Scholarship. Be sure to include the chapter activity(ies) in which you have participated, the type(s) of involvement you have had, and their meaning to you as a Kadelpian and future educator.
I ______, hereby make application for the Fortgang – KDP Chapter Service Scholarship and authorize the Selection Committee to review my academic records.
______
SignatureDate
Please forward your application directly to: Becky Hawbaker, KDP Faculty Counselor, SEC 153B, University of Northern Iowa, Cedar Falls, IA 50614. The absolute deadline for receipt of applications and materials is NOON on Thursday, January 26, 2017, so those who are interested should begin the application process immediately! Late applications will not be considered. The recipient of the Fortgang–KDP Chapter Service Scholarship will be announced during the fall initiation program on Sunday, February 12thin the Commons Ballroom.