ORDER OF AHEPAand

DAUGHTERS OF PENELOPE

CAPITAL DISTRICT #3

COLLEGE SCHOLARSHIP

APPLICATION

ACADEMIC YEAR 2007

WASHINGTON, DC VIRGINIA MARYLAND NORTH CAROLINA WEST VIRGINIA

Dear Applicant:

Please read the following instructions thoroughly before completing this application.Your application begins on PAGE 4.

MAKE SURE ALL necessary documents are included with your application:

TranscriptsB. SAT Scores (High School and College Freshman only)C. Copies of Certificates (If any)D. Written Essay - a 300 word essay is required.E. Any other documents you wish to have reviewed with your application.

DO:

MAKE SURE your application is postmarked no later than APRIL 1, 2007.MAKE SURE you have ALL required signatures. If your Chapter President orSecretary is not available, have the Vice President sign the Chapter certification.MAKE SURE you mail the application package to the mailing address stated onPage 3.MAKE SURE you are a child (not niece, nephew, grandchild, cousin, etc.) ofeither an AHEPAN or a Daughter of Penelope.MAKE SURE your sponsoring Chapter (Chapter of the President and VicePresident) is in good standing. This means the Chapter must have paid all of itsDistrict and National per capita dues by 12/31/2006 for all of its members. Toconfirm eligibility contact your sponsoring Chapter or the District Marshall.MAKE SURE you have a GPA of at least 2.5.MAKE SURE you submit pages 4, 5, and 6.MAKE SURE you submit pages 4, 5, 6, 7 and 8 if you require financial aid.MAKE SURE you submit a recent passport size photo.

DON'T:

Submit an application if you are a graduate student, post graduate student or arein Law or Medical School.Submit an application unless you are a child of either an AHEPAN or a Daughterof Penelope.Return the cover page or these instruction sheets (pages 1-3).

PAY CLOSE ATTENTION TO THE FOLLOWING:

It is very important that you score as high as possible on your essay. As you can see onthe following page, the essay carries 30 possible points.

• The essay must be 300 words in length.• The essay must have a HEADING or TITLE• Your essay must address the topic "The Value of a College Education."• Check your grammar and spelling.• Your essay must be typed - one and a half spacing preferred.

o Use standard type without italics, bolding or graphics.o Times Roman or Arial fonts are preferred.o 10 or 12 point size

• Use white paper.

Capital District 3 Scholarship Application Form-F (Rev. 12/04/2006) 2 of 8

A.

•

•

••

••

•

•

•

•

•

SCHOLARSHIP APPLICATION SCORING CRITERIA

COLLEGE UPPER CLASS:

Grade Point Average possible 40 pointsDean's List possible 10 pointsHonors/Extra Curricular Activity possible 10 pointsPart Time EmploymentEssay

Total 100 points

HIGH SCHOOL SENIOR OR COLLEGE FRESHMAN:

SAT Score possible 10 pointsClass Standing Top percent of Class possible 10 pointsGrade Point Average

possible 10 points

possible 20 pointsNational Honor Society possible 10 pointsHonor/Extra Curricular Activities possible 20 pointsEssay

Total 100 points

PLEASE MAIL THE COMPLETED APPLICATION & SUPPORTING DATA TOCAPITAL DISTRICT NO. 3 MARSHALL:

Larry Odzak204 Pineview Road

Durham, NC 27707-2846Phone: 919-489-8042

Email: odzak@verizon.net

(Do not hesitate to call or email if you have any questions.)

Capital District 3 Scholarship Application Form-F (Rev. 12/04/2006) 3 of 8

possible 30 points

possible 30 points

SCHOLASTIC ACHIEVEMENT SCHOLARSHIP APPLICATIONTO BE COMPLETED BY ALL APPLICANTS. Please note the entire application packagebecomes the property of the Scholarship Foundation and will not be returned. CHECK ONLYONE BOX BELOW AND PROCEED ACCORDINGLY.

SCHOLASTIC ACHIEVEMENT (Complete pages 4, 5, and 6)FINANCIAL NEED (Complete pages 4, 5, 6, 7 and 8)

2. Home Address:

(Last, First, MI)

3. Telephone Number:

4. Date of Birth:

5. Social Security Number:

6. College or University you will be attending in the Fall:

City:

7. To be eligible you must have a grade point average of at least 2.5 and check one ofthe following:

Be a son or daughter of a member in good standing of either the ORDER OF AHEPA orThe DAUGHTERS OF PENELOPE in District #3.

8. Credentials required: (Attach to Application)

High School Senior:

High School TranscriptClass RankGrade Point AverageSAT Scores

College Freshman:

High School TranscriptClass RankGrade Point AverageSAT ScoresCollege Transcript &Grade Point Average

College Upper Classman:

College TranscriptGrade Point Average

Capital District 3 Scholarship Application Form-F (Rev. 12/04/2006) 4 of 8

1. Name of Applicant:

State:

Name of College Registrar:

Be a son or daughter of a deceased member of either the ORDER OF AHEPA or TheDAUGHTERS OF PENELOPE in District #3.

Be a member in good standing of the ORDER OF AHEPA, DAUGHTERS OFPENELOPE,SONS OF PERICLES OR MAIDS OF ATHENA.

(Mailing Address)

Scholastic Achievement Application (cont.)

9. List all honors, awards (e.g., National Honor Society, Dean's List (Number of Awards),extracurricular activities, etc.).

10. List employment history (part and full time).

11. All applicants must attach a three hundred (300) word essay on: "The Value of aCollege Education."

12. All applicants must submit a recent photo per the instructions in the space below.

ATTACH A RECENTPASSPORT SIZE

PHOTO OF YOURSELFHERE

APPLICANT CERTIFICATION:

Everything I have submitted is true to the best of my knowledge and belief.

Capital District 3 Scholarship Application Form-F (Rev. 12/04/2006) 5 of 8

DATESTUDENT SIGNATURE

PARENT/GUARDIAN SIGNATURE DATE

CHAPTER CERTIFICATION(To be completed by the sponsoring AHEPA or DOP chapter)

Our Chapter hereby submits the application of:

Name:

This application appears to meet all of the eligibility criteria established and we herebyrequest it be reviewed for consideration. This applicant or his/her parent is a member ingood standing at the time of the application.

CHAPTER PRESIDENT CHAPTER VICE PRESIDENT/SECRETARY

CHAPTERS WHO HAVE PAID BOTH THEIR NATIONAL AND DISTRICT PERCAPITA TAX IN FULL ARE ELIGIBLE TO SUBMIT APPLICANTS. (GOOD STANDING

MEANS A CHAPTER IS PAID THROUGH DECEMBER 31, 2006.)

NO SCHOLARSHIP APPLICTION WILL BE CONSIDERED UNLESS THECOMPLETED APPLICATION, REQUIRED CREDENTIALS AND THE 300

WORD ESSAY IS POST MARKED NO LATER THAN APRIL 1, 2007.

PLEASE MAIL THE COMPLETED APPLICATION & SUPPORTING DATA TO THECAPITAL DISTRICT NO. 3 MARSHALL:

Larry Odzak204 Pineview Road

Durham, NC 27702-2846Email: odzak@verizon.net

Capital District 3 Scholarship Application Form-F (Rev. 12/04/2006) 6 of 8

Print Name Print Name

Signature

Date Date

Chapter Name & Number Chapter Name & Number

Signature

IMPORTANT

FINANCIAL NEED SCHOLARSHIP APPLICATION

Please also complete the following questionnaire if you are applying on the basis of financial need.Make sure to answer all questions. (Use N/A if the question does not apply.) (PLEASE PRINT)

Name:

Address:

Do you live with your parents?

Are you a U.S. Citizen?

If not a permanent resident, indicate Alien Registration Number:

If No, explain status/ type of visa:NOTE: IF YOU ANSWERED "NO" TO ALL OF THE ABOVE,

CONTACT THE DISTRICT MARSHALL

College Major:

List all colleges/universities you have attended, whether you received financial aid or not. Also, listcredit hours earned.INSTITUTION CITY & STATE DATES ATTENDED CREDIT HOURS

Have you applied for financial aid through the FAFSA?

If YES, what type of aid are you receiving or do you expect to receive?

Have you applied for financial aid at your college/university?

If YES, please explain what aid are you receiving or expecting to receive?

Do you anticipate receiving any outside scholarships?

If YES, source:

Your parents' current marital status:

Married

Capital District 3 Scholarship Application Form-F (Rev. 12/04/2006) 7 of 8

Anticipated Graduation Date:

Separated WidowedDivorced

Yes No

Yes No

NoYes

No

Yes No

Yes

Work StudyPell Grant SEOG Stafford Loan Other

SSAN: Date: 20

Zip Code:State:City:

Amount:

Financial Need Application (cont.)

Number in your parents' household in 2006 (Include yourself and parents. Do not includeyour parents, other children or any other person, unless they are claimed for tax purposes.)

Student's expected income for 2007 (Income earned from work by you):

Other taxable income:

Parents' expected income in 2007:

Income earned from work by your father:

Non-taxable income:

Student's cash, checking and saving accounts:

Parents' cash, checking and savings accounts:

Business Value:

Please list any circumstances, which will affect your financial situation during academic year 2007.

APPLICANT CERTIFICATION:

Everything I have submitted is true to the best of my knowledge and belief.

Capital District 3 Scholarship Application Form-F (Rev. 12/04/2006) 8 of 8

Non-taxable income & benefits:

Income earned from work by your mother: Other taxable income:

Other Real Estate & Investments Value: Debt:

Earned Value:Debt: Debt:

DATESTUDENT SIGNATURE

PARENT/GUARDIAN SIGNATURE DATE