Scholarship Application/FAQ
 
 
Last Name:        
First Name:           MI:
Phone #:            
Address:            
City:                  
State:                     Zip:   
Date of Birth:     /  /         Gender
Email Address: 
Parent(s) / Guardian
 
Father:              
Occupation:      
Address:            
Phone #:            
Employer:          
Employer Phone #:          
 
Mother:              
Address:            
Phone #:            
Employer:          
Employer Phone #:            
 
Guardian:          
Address:            
Phone #:            
Employer:          
Employer Phone #:            
Guardian's relationship to Applicant:        
 
Number of Siblings:    Ages                
Who in your Family has Cystic Fibrosis?:  Self   Other
If you selected other, please specify:  
 
 
THIS SECTION MUST BE FILLED OUT COMPLETELY TO BE CONSIDERED FOR THE SCHOLARSHIP
 
College(s) to which you have applied:
1.     2.  
3.     4.  
If you have been accepted, where?:   
Intended Major:   
Expected Date of Enrollment:      /    /  
Score for ACT:        Date of Examination     /    /  
Score for SAT:        Date of Examination     /    /  
Verbal Score:        Quantitative Score  
Overall Acedemic GPA :            On a     point scale.
 
 
DANA WALTERS SCHOLARSHIP FOUNDATION INC.
 
Name:        
Address:      
City:            
State:               Zip:     
Date of Birth:     /  /       SSN  / 
What Colleges are you interested in attending?:
1.     2.  
3.     4.  
 
What careers are you considering and why?
 
 
In what community or church activities have you participated?
 
What special recognition, honors, prizes, scholaships, awards, etc. have you received, in or out of school?
 
Describe yourself as an indivdual (e.g. strengths, weaknesses, demonstrated leadership behaviors and organizational skills).
 
What have you done to further the CF cause for our families? List any fundraising activities, educational activities or research studies you have been a part of.
 
 
INDICATE YOU WORK EXPERIENCE.
List your most recent job first.
 
Employer:        
Kind of work:  
Date Began:     /  /       Date Ended  /  /  / 
 
Employer:        
Kind of work:  
Date Began:     /  /       Date Ended  /  /  / 
 
Employer:        
Kind of work:  
Date Began:     /  /       Date Ended  /  /  / 
 
Employer:        
Kind of work:  
Date Began:     /  /       Date Ended  /  /  / 
 
Additional Information. Tell me something that would help me know you better. You might relate some event that has changed your life or beliefs. You might discuss an issure about which you have strong feeling. Use you imagination!
 
 
References
Submit three letters of reference from persons not related to you who know you well and would be willing to recommend you. See G"uidelines" page. You must include YOUR name and phone number on each reference for.
 
 
Certification
Important: Review this form and make certain you have responded accurately to all items.
I certify that all of the statements made in this application form are true, complete, and correct to the best of my knowledge and belief. and are made in good faith.
Yes No Name:   Date:   /  /      
School Name:        
School Address:      
City:         State:       Zip:  
Contact Person:      Phone #  
 
 
     
 
OR...
Letter of acceptance from your post-secondary educational institution.
For a guidline for the letters that should be submitted from your references ... click below.
 
 

Checklist for submitting the application package.
Assemble your Application Package in the following order:
l. The official application form fully completed and signed.

2. Verification of your SAT/ACT and GPA or letter of acceptance from your post secondary educational institution.

3. THREE letters of reference from persons not related to you who know you well and are willing to recommend you. Be sure YOUR name and phone number are included on each reference letter.

4. Return this completed package to the scholarship committee no later than March 6, 2010 to be considered for the 2010 award.

DOS AND DON'TS

Do allow yourself at least 2-3 weeks to complete your application package.

Do complete and send your application package as EARLY as possible to make sure that it will reach us by the deadline.

Don't put the application package into a binder, notebook or acetate cover.

Don't wait thinking that you probably won't get the scholarship. Someone has to win it. It might as well be YOU!!!!!

Your picture is optional but we would really like to have it included in your application.

MAIL YOUR APPLICATION TO THE DANA WALTERS SCHOLARSHIP FOUNDATION, INC. P. O. BOX 723243, ATLANTA, GA 31139 OR CALL 770 436-0190

KAREN WALTERS, PRESIDENT

 
DID YOU KNOW?
 

FACTS YOU NEED TO KNOW ABOUT THE DANA WALTERS
SCHOLARSHIP FOUNDATION 
 

You don't have to have Cystic Fibrosis in order to qualify for the scholarship. You need only be an immediate member of a family with a person with CF. That includes Moms and Dads too!!

Once you qualify for the scholarship it is yours until you complete your four year degree--even if it takes more than four years.

Income is not an issue. The Dana Walters Scholarship Foundation was established to help persons become self sufficient and build self esteem.

It does not matter what college you plan to attend. If you are awarded the scholarship you can go anywhere you choose.

The scholarship foundation will make your payment directly to the college of your choice of you can submit bills that you have already paid for reimbursement.

We have an internship program to help not only scholarship recipients but anyone with Cystic Fibrosis find a job that is suited to his or her talent. This does not mean that you have to have completed a degree in order to be able to participate.

There are health clubs that will work with the Cystic Fibrosis community to make sure that you stay as healthy as you can while you are in school or working.

The Dana Walters Scholarship Foundation has speakers that will be glad to address your workplace or community club free of charge. We want to spread the message so that everyone will participate.

 
Email: sonickaren@aol.com