Contact Information

First Name:

Middle Initial:

Last Name:

School

Home

Address:

Address:

Address2:

Address2:

City:

City:

State:

State:

Zip:

Zip:

Daytime Phone:

Daytime Phone:

Evening Phone:

Evening Phone:

E-mail Address:

E-mail Address:

Academic Information

College/University:

Major:

Degree:

Graduation Year:

Cumulative GPA:

Greek Heritage

Relative's Name:

Relationship

Where From:

Relative's Name:

Relationship

Where From:

Awards, Scholastic Honors, and Other Achievements

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Activities (College, Church, Community), Internships, and Employment

Activity:

Office/Position:

Activity:

Office/Position:

Activity:

Office/Position:

Activity:

Office/Position:

Financial Information

Annual Tuition:

Room/Board Expenses:

Are you receiving financial aid from the government?

Amount of gov't loans:

Amount of gov't grants:

Are you receiving financial aid from the college?

Amount of school loans:

Amount of school grants:

Total aid package amount:

Total debt burden:

Required Essay

In an essay completed separately but submitted with this application, please describe what values from your Greek heritage you hope to carry with you into your career as a journalist.

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To the best of my knowledge, the information above is complete and accurate. I give permission for a copy of my transcript to be forwarded to the Agris family and the Alpha Omega Council Scholarship Committee.