Scholarship Application

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The Burlington-Camden Achievement Foundation (BCAF) is currently accepting applicationsfor its 2011-2012scholarship program. Successful applicants will be graduating male students who are able to competively demonstrate their qualifications in the areas of service and achievement both presently and with intentions for thfuture. Application requirements include:

Completed scholarship application with required signatures

Official high school transcript

College/university acceptance letter(s)

(2) typed five-hundred word essays

1. What are your long-term career goals and how do you plan to apply your career goals to benefitsociety?

2. Please describe the traits that you believe a college student should possess and how you currently embody those characteristics.

Completed recommendation form (sealed and initialed envelope)

Specific elgiblity requirements include:

All applicants must: agree to attend scholarship award ceremony on June 30, 2012 if selected

Students attending private, parochial or public high schools and residing in Burlington, Camden, orGloucester County, NJ

Have a cumulative HS GPA of 2.75 or higher

Participate in extra-curricular, service and/or leadership activities

Be male

Be a first-year, first-time, student attending at an accredited four-year college/university in fall 2012

Not be related to any member of the BCAF Board of Directors

All application materials must be turned in together as a single submission postmaked by May 15, 2012. Noincomplete or late applications will be considered. After completing and printing, please be sure to sign theapplication as indicated. Electronic applications can be accessed and downloaded fromhttp://www.kappasofburlcam.org/. Packets should be mailed via U.S. postal service in ONE envelope to:

Dr. Shannon Gary

Drexel University, Pennoni Honors College

5016 MacAlister Hall

Philadelphia, PA 19104

The Burlington-Camden Achievement Foundation (BCAF) is a charitable and educational non-profit entity. Founded and incorporated in 2011, BCAF exi

to help students realize their post-secondary goals. The Foundation provides scholarships, leadership training, and other types of assistance. BCAF is governed

board of directors comprising members from the Burlington-Camden (NJ) Alumni Chapter of Kappa Alpha Psi Fraternity, Inc.

The Burlington-Camden Achievement FoundationScholarship Application - $1000 awardDEADLINE: May 15, 2012

http://www.kappasofburlcam.org/





ELIGIBILITY REQUIREMENTS: All applicants must: agree to attend scholarship award ceremony on June 30, 2012 if selected; reside in BurlingtCamden, or Gloucester County, NJ; have a cumulative HS GPA of 2.75 or higher; participate in extra-curricular, service and/or leadership activities; be mal

a first-year, first-time, student attending at an accredited four-year college/university in fall 2012; and not be related to any member of the BCAF Board of

Directors.

APPLICANT INFORMATION

Full Name: Date of Birth:

Street Address:

City: State: Zip:

Telephone: Email:

FAMILY INFORMATION

Father/Guardian:

Street Address:

City: State: Zip:

Telephone: Email:

Mother/Guardian:

Street Address:

City: State: Zip:

Telephone: Email:

SCHOOL INFORMATION

High School: Graduation Date:

GPA: SAT/ACT Score: Class Rank:

Name of College or University:

Street Address:

City: State: Zip:

Intended Major:

ACTIVITIES, EMPLOYMENT & DISTINCTIONS

Club/Org.: Role: Participation Length:



Employer: Position: Employment Length:

Honors & Recognitions:

The Burlington-Camden Achievement FoundationScholarship Application - $1000 award

DEADLINE: May 15, 2012



Certification and Signatures

I (we), certify that the information submitted on this application is true and complete to the best of my (our)

knowledge. If asked by any authorized official of the Burlington-Camden Achievement Foundation (BCAF), I (w

agree to give the documentation for information given on this application. I (we) realize that failure to comply wi

a request for additional information may prevent the applicant from receiving the award. I (we) understand that t

scholarship money will be awarded to the student upon official written verification of college enrollment. I also

grant BCAF permission to use my photograph and/or selected quotes on their website and in future publications

_______________________________________________________________________________________________ Applicant Signature

_______________________________________________________________________________________________Parent/ Guardian Signature Date



Applicant’s Name: _________________________________ Date: ___________________

Note: Signature grants permission for recommender to send information.

_______________________________________________________________________________________________ Applicant Signature

_______________________________________________________________________________________________Parent/ Guardian Signature Date

Academic Evaluation (Check the appropriate column with your estimate of each trait listed)

Outstanding Good Average Below AverageNo Basis fo

Judgment

Academic

Ability

Academic

Performance

Academic

Motivation

Academic

Growth Potential

Personal Evaluation (Check the appropriate column with your estimate of each trait listed)

Outstanding Good Average Below Average

No Basis fo

Judgment

Originality

Independence

Leadership

Maturity

Initiative

Trustworthiness

Resilience

The Burlington-Camden Achievement FoundationScholarshi Recommendation Form



In what context and for how long have you known the applicant?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Please provide any additional thoughts on the applicant.

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

How do you think this applicant will perform in college?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Name of Recommender ___________________________________________________________________________

Position Title ___________________________________________________________________________________

Signature _______________________________________________________________________________________

Date __________________________ Phone Number ________________________ Email ____________________

Documents

Scholarship Application