Research Triangle Park (RTP)
Black Diversity Network Group
Scholarship Application
Background:
The mission of the RTP Black Diversity Network Group is to embrace and support its members to achieve their aspirations, by reaching out, reaching back, and propelling each other forward. When building up a community we understand none of us is as strong as all of us. This scholarship has been established to support graduating African American high school students in the Wake, Durham and Orange Counties of the Research Triangle Park area in North Carolina in pursuing their educational aspirations and desire to make a positive contribution to their communities.
Scholarship Criteria:
• Must be African American
• Must be a resident of Wake, Durham, or Orange Counties in North Carolina
• Must be a graduating high school senior
• Must have a weighted G.P.A of 2.75 or above
• Must be involved in community service
• Must be planning to attend an accredited two or four-year college or university
Research Triangle Park (RTP)
Black Diversity Network Group
Scholarship Application
Please type.
I. General Information
Last Name:
First Name:
Middle Initial:
Mailing Address:
City:
State:
Zip Code:
Contact Phone:
E-mail Address:
Are you African-American?
Are you a resident of Wake, Durham, or Orange County?
II. Educational Information
High School (Currently Attending):
High School GPA:
Please provide a copy of your most recent official transcript.
College or University (2 or 4 year accredited college or university you plan to attend in Fall):
Have you applied for admission to the above college or university?
If yes, have you been accepted:
Intended major / area of study:
Type of degree you are/will be pursuing:
Associate degree in
Bachelor degree in
III. Personal Information
Please list any community service activities, extracurricular activities and/or work experience:
Please list any awards/honors you have received:
IV. Financial Information
ATTACH A ONE PAGE, DOUBLE-SPACED, TYPED, STATEMENT OF YOUR FINANCIAL NEED FOR THE NEXT ACADEMIC YEAR TO THIS PAGE. Please show anticipated monies received versus anticipated expenses. Anticipated monies would be any scholarships, grants, loans, wages or assistance from parents and /or relatives.
V. Essay
Please provide an essay that addresses 3 of the 4 following questions:
- Why is a good education important in society today?
- How will you use the education that you receive?
- How will you take what you have learned and contribute back to your community
to help future generations?
- How have your extra-curricular activities made a difference in your community?
The essay should be typed, double-spaced and between 500-800 words.
VI. References
Applicants must submit two letters of recommendation. One from a high school teacher and one from a person who has known the applicant for two or more years, and who is not a relative or member of the applicant’s family. Suggested references would be employers, counselors or ministers.
VII. Scholarship Agreement
• I give my permission for the release of academic, financial, and/or other necessary
information requested by the scholarship/award selection committee.
• I certify that the information throughout this application is accurate (and in compliance with
the criteria stated on the scholarship criteria), and that any misrepresentation of any facts or details will result in my ineligibility for any and all portions of the scholarship award.
• I hereby agree to the terms specified in the scholarship criteria upon accepting the
scholarship award. However, should my status change whereby I no longer meet the criteria, I understand that the scholarship will be revoked.
• I agree to provide a statement or letter of acceptance from an accredited college or university by July 15, 2008. Failure to enroll in an accredited college or university will result in the withdrawal of the award and the student will be obligated to repay any monies received.
• The scholarship award monies will be sent and applied to the student account of the recipient
at the accredited college or university in which s/he enrolls.
Signature:
Date:
Checklist
Make sure the following items are completed and included in your application packet.
I. General Information
II. Educational Information
III. Personal Information
IV. Financial Information
V. Essay
VI. Letters of Recommendation
VII. Transcript
Deadlines
1. SCHOLARSHIP APPLICATION DEADLINE: Postmarked by May 16th, 2008.
2. STATEMENT / LETTER OF ACCEPTANCE FROM AN ACCREDITED
COLLEGE OR UNIVERSITY DEADLINE: Postmarked by July 15th, 2008.
Contact Information
Please mail all items to the address listed below:
RTP Black Diversity Network Group Scholarship Committee
P.O. Box 12887
Durham, NC 27709-2887
If you have any questions please send an e-mail to: rtp_bdng_scholarship@yahoo.com












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