Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Name of Reference *

First

Last

Email Address of Reference *

Date *

I have demonstrated my financial need by completing the FAFSA form for the current school year. * *

Please describe how this scholarship award will financially benefit you as a member of the Lambda Chi Alpha chapter and as a student at Drury. Include a statement about how you will give back to the chapter, now and in the future, because of this award. *

Please list your activities (clubs, volunteerism, etc.) at Drury (in addition to your fraternity) and in the community since coming to Drury. Next to each organization, please include a description of your participation and role(s) such as leadership positions held. *

Ben A. Parnell Lambda Chi Alpha Scholarship Application