Alpha Tau Omega Foundation: Steven Haisley Memorial Scholarship Application

This scholarship is dedicated to the memory of Steven Haisley, Cincinnati 00’. Steven passed August 12, 2006 and will be remembered forever by his brothers. Steve, always laid back and care free, was the consummate ATO Brother. Heavily involved on campus and dedicated to his studies, Steve, was a member of many campus organizations and excelled academically. Despite campus and academic rigors, ATO was his home and his family. He always made time for Delta Lambda. It is certain that Steven was the type of brother our founders envisioned when developing the Alpha Tau Omega Fraternity.

If you are interested and qualified, complete this application and attach your transcript, one letter of recommendation and a current resumé, and return the application with attachments to address below by March 21, 2008.

The award is based on the following criteria:

Each candidate shall be an initiated or uninitiated (pledge) member of the Delta Lambda chapter of Alpha Tau Omega.
Each candidate shall excel in academic achievement, extracurricular activities and individual character.

The ATO Foundation will award a $1,000 scholarship in Spring 2008.

If you prefer, you may download a Microsoft Word document of this application form here and mail it to the Steven Haisley Scholarship Selection Committee.

All sections of this application should be completed.

Personal Information

Name of Applicant
E-Mail Address
Social Security Number (123-45-6789)
Date of Birth (mm/dd/yyyy)
Home Telephone Number (123-456-7890)
Mailing Address (Street Name & #)
City
State
Zip Code
Cell Number (123-456-7890) *Optional
Major(s)
Minor(s)
Cumulative Grade Point Average (on a 4.0 scale)
Expected Date of Graduation (mm/dd/yyyy)

Financial Information


Are you currently receiving financial assistance:	Yes No
If yes, from where:
How Much?
Have you received any scholarships:	Yes No
If yes, from whom:
How Much?

Essays

Read this before answering the following questions:

Please keep answers to each question at 1000 words or less.

1. Describe your general college activities, professional societies, offices held and participation in community activities.

2. What are your career objectives after college?

3. Who is a role model in your life and why?

4. What is your strongest attribute? Weakness?

**Please note: ATO reserves the right to verify any information contained in this application. Any falsification will result in immediate disqualification.

Signature and Verification

Signature (type your name)

Date (mm/dd/yyyy)

Approval Authority

Approval Authority Name

Approval Authority Telephone
(123-456-7890)

I, [[Your Name]], aver that I am in good standing with my chapter and all of the information provided is true and accurate to the best of my knowledge/belief. I further aver that this application has been approved by my Chapter President, [[Authority Name]], at telephone [[Authority Phone]].

All applications and supplemental documentation (one transcript, one letter of recommendation and a current resumé) must be sent to the Steven Haisley Scholarship Selection Committee and received by March 21, 2008.

Alpha Tau Omega Foundation
Steven Haisley Scholarship Selection Committee
867 Ward-Koebel Rd.
Oregonia, OH 45054
Email: brianhaisley@yahoo.com

32 East Washington Street, Suite 1350
Indianapolis, IN 46204

Phone: (800) 508-5131
Fax: (317) 472-0945

Notice: Alpha Tau Omega does not have chapters or affiliated organizations in the Philippines or in any other countries or territories outside of the United States. Use of ALPHA TAU OMEGA or ATO by any organizations outside the United States is prohibited without written permission from ATO National Headquarters.