Alabama State University Birmingham Alumni Association

Alabama State University

Birmingham Alumni Association

Scholarship Application

Dear Applicant,

Thank you for your interest in Alabama State University. As members of the Alabama

State University Alumni Association, we are proud that you have chosen to attend a

university that sets high standards for their students. We hope that your tenure at ASU

will be a rewarding one. Alabama State University has provided all of its students with

the opportunity to receive a quality education. In keeping with the university’s proud

tradition, we are offering you the opportunity to apply for the ASU Alumni Association

Birmingham Chapter Scholarship. The scholarship committee has set five objectives for

its applicants:

1.) Academic Excellence

2.) Character

3.) Leadership

4.) Community Service

5.) Financial Need

We believe that these objectives are important to become a great asset in today’s society.

Application Criteria:

1.) Grade Point Average 2.75 or higher

2.) Official Transcript with counselors printed name and signature

3.) Completed Application and participation in scheduled interview

4.) Three (3) Letters of Recommendations (Ex: Counselor, Teacher, Employer)

5.) Birmingham/Jefferson County Resident

6.) A 500 – 750 words essay on the following:

Explain how Alabama State University will define your role in America’s

society, as well as enhance your career goals.

7.) Uploaded photograph of applicant.

APPLICATION MUST BE COMPLETED BY: 11:59 P.M. ON April 8, 2019

PLEASE EMAIL COMPLETED APPLICATION TO:

[email protected]

Alabama State University

Birmingham Alumni Association

Scholarship Application

Please type or print

Name: _____________________________________________________

Address: ___________________________________________________

City: ____________________ State: _________ Zip Code: __________

Home: __________________ Cell: __________________

Email: ____________________________________________________

High School: _______________________________________________

City: ________________________ State: ______ Zip Code: ________

Have you been admitted to ASU? Yes ( ) No ( )

Parent Information

Mother’s Name: _________________________________________________________

Address: _______________________________________________________________

City: _________________________ State: _____________ Zip Code: _____________

Home: __________________ Cell: __________________ Other: __________________

Email: __________________________________________________________________

Employer: _______________________________________________________________

Position: ______________________ Work: ________________ Extension: __________

Father’s Name: __________________________________________________________

Address: _______________________________________________________________

City: _________________________ State: _____________ Zip Code: _____________

Home: __________________ Cell: _________________ Other: _________________

Email: _________________________________________________________________

Employer: ______________________________________________________________

Position: ______________________ Work: ________________ Extension: _________

Household Information

Number in Household : _______ of which how many will be attending college? ____

Total Household Income: ____________

Application Deadline April 8, 2019

Personal Achievements

Academic Achievements

__________________________________________________________________

Extra-Curricular Activities

__________________________________________________________________

Community Activities

__________________________________________________________________

Leadership Positions

__________________________________________________________________

___________________________________ __________________

Signature Date

Application Deadline April 8, 2019

Alabama State University

Birmingham Alumni Association

Scholarship Application

Instruction for Letter of Recommendation

Using the guidelines below, please provide a brief recommendation for this applicant.

1. Your recommendation should include references to the applicant’s character, integrity and

motivation; it may be based on a professional and/or personal relationship.

2. Include the following information:

a. Your relationship to the applicant

b. Length of time you have known the applicant

c. Your printed name, original signature, phone number, email address, and current date

3. Length of the recommendation should not exceed one page.

4. Please type your essay.

5. The student MUST email completed application packet to

ASU1867NAABHAM@gmail.com by 11:59PM on April 8, 2019.

Letters of recommendation not included in the packet will NOT be

considered and will cause the applicant’s file to be ineligible for

consideration.

Alabama State University

Birmingham Alumni Association

Scholarship Application

RECOMMENDATION FORM

NAME: ________________________________________________________________

POSITION: ______________________________ PHONE: ______________________

Email address: ___________________________________________________________

How long have you know applicant? __________________________________________

In what capacity? ________________________________________________________

Please rate the student from 1 to 4 with 4 being the highest.

1 2 3 4

Dependability

Leadership

Character

Personal Appearance

Personality

Academic Performance

Please list applicant’s strengths and weakness.

________________________________________________________________________

Remarks:

________________________________________________________________________

__________________________________ ____________

Signature Date

Alabama State University

Birmingham Alumni Association

Scholarship Application

RECOMMENDATION FORM

NAME: ________________________________________________________________

POSITION: ______________________________ PHONE: ______________________

Email address: ___________________________________________________________

How long have you know applicant? __________________________________________

In what capacity? ________________________________________________________

Please rate the student from 1 to 4 with 4 being the highest.

1 2 3 4

Dependability

Leadership

Character

Personal Appearance

Personality

Academic Performance

Please list applicant’s strengths and weakness.

________________________________________________________________________

Remarks:

________________________________________________________________________

__________________________________ ____________

Signature Date

Alabama State University

Birmingham Alumni Association

Scholarship Application

RECOMMENDATION FORM

NAME: ________________________________________________________________

POSITION: ______________________________ PHONE: ______________________

Email address: ___________________________________________________________

How long have you know applicant? __________________________________________

In what capacity? ________________________________________________________

Please rate the student from 1 to 4 with 4 being the highest.

1 2 3 4

Dependability

Leadership

Character

Personal Appearance

Personality

Academic Performance

Please list applicant’s strengths and weakness.

________________________________________________________________________

Remarks:

________________________________________________________________________

__________________________________ ____________

Signature Date

Alabama State University

Birmingham Alumni Association

Scholarship Application

ACKNOWLEDGMENT STATEMENT

In order to evaluate applications fairly and to preserve the integrity of the preparation

process, the scholarship committee requests that every applicant complete an

acknowledgment statement. Each applicant is expected to thoroughly complete his or her

own packet.

Statement of Understanding

I certify that the information in this application is true and correct to the best of my

knowledge. I understand that I will be disqualified if I include false information in this

application. I agree to abide by the conditions of the Scholarship Committee and in no way

shall question their selection of the winners. I understand that the Birmingham Alumni

Chapter of Alabama State University Scholarship Committee reserves the right to contact

individuals listed on this application. UPON COMPLETION OF DEGREE AT

ALABAMA STATE UNIVERSITY, YOU ARE ENCOURAGED TO JOIN AN

ALUMNI CHAPTER.

Disbursement

I understand that all funds will be disbursed directly to Alabama State University and

available on or before SEPTEMBER 20, 2019. Recipients must use the scholarship for

basic educational expenses such as tuition, laboratory fees, dormitory fees, boarding

expenses, books, equipment necessary for classes, and/or any miscellaneous fees required by

the university.

PRIVACY ACT STATEMENT

Under authority of U.S. Title 10, Section 3012, the enclosed personal information will be

maintained by the Scholarship Committee for administrative use and released only to the

individuals needed to evaluate the application. The disclosure of the information is voluntary;

however, failure to disclose all or part of the requested information may hinder evaluation of

the application. The application will remain in the possession of the Scholarship Committee

for one year and will then be destroyed.

_____________________________________ ________________________

Signature of Applicant Date

Alabama State University

Birmingham Alumni Association

Scholarship Application

ESSAY Guidelines

Topic:

Explain how Alabama State University will define your role in America’s society,

as well as enhance your career goals

Keep in mind the following:

1. The essay should be:

-spaced, with one inch margins

- 750 words

2. The essay will be evaluated on style and content, and must be grammatically correct.

3. Points will be deducted from essays that exceed the word limits.

Alabama State University

Birmingham Alumni Association

Scholarship Application

ESSAY Guidelines

Topic:

Explain how Alabama State University will define your role in America’s society,

as well as enhance your career goals

Keep in mind the following:

1. The essay should be:

-spaced, with one inch margins

- 750 words

2. The essay will be evaluated on style and content, and must be grammatically correct.

3. Points will be deducted from essays that exceed the word limits.

Alabama State University

Birmingham Alumni Association

Scholarship Application

APPLICANT CHECKLIST

(For your use only, Do NOT Return)

Please submit your completed application with its contents in the following order:

______ 1. Completed application with uploaded photograph

______ 2. Essay – including your word count provided at the end of the essay.

______ 3. Scanned/uploaded and signed recommendation form or letter.

______4. Signed acknowledgment statement

Entire packet must be EMAILED by April 8, 2019.

ASU1867NAABHAM@gmail.com

NO LATE ENTRIES OR ADDITIONS WILL BE ACCEPTED.

If you have any questions about the application, please call:

Mrs. Cynthia Bonner, Chapter President

205-914-5456

Or

Mr. Alton Mitchell, Scholarship Chair

205-266-0576