Lloyd Balfour Application

Instructions

Complete all of the required fields. Upon successful completion, submit your electronic application by hitting the Submit button at the bottom of this page. You will then be presented a finished version for you to print and mail in with the Additional Materials that are required to complete this application.

* = Required fields

Application Form

Applicant's Information

First Name *
Middle Name: (optional)
Last Name *
Citizenship *
Intended Career *

E-mail Addresses

E-mail Primary *
E-mail Secondary: (optional)

Phone Numbers

Phone Primary (xxx) xxx-xxxx*
Phone Secondary: (optional)

Current Address

Address Line 1 *
Address Line 2: (optional)
City *
State/Provience *: (required for US/Canada)
Region: (outside US/Canada)
Zip/Postal Code: (required for US/Canada)
Country *

Permanent Address (if different from above)

Address Line 1
Address Line 2: (optional)
City
State/Provience: (required for US/Canada)
Region: (outside US/Canada)
Zip/Postal Code: (required for US/Canada)
Country

Fraternity Affiliation

Fraternity *
Chapter *
Year Initiated *
Fraternal and Interfraternal Service (activities and offices held)*

Undergraduate Institution #1

School/University *
School State *
Start Date *: (month) (year)
End Date (graduation, transfer, or expected date of graduation)*: (month) (year)
Degree Earned *
Cumulative GPA *
Major(s) *
Minor(s)
Campus and Community Service (Activities and offices held)
Extracurricular Activities (Honors, Awards, Honor Societies)

Undergraduate Institution #2 (if applicable)

School/University
School State
Start Date: (month) (year)
End Date (graduation, transfer, or expected date of graduation)*: (month) (year)
Degree Earned
Cumulative GPA
Major(s)
Minor(s)
Campus and Community Service (Activities and offices held)
Extracurricular Activities (Honors, Awards, Honor Societies)

Graduate Institution #1

School/University *
School State *
Start Date *: (month) (year)
End Date (graduation, transfer, or expected date of graduation)*: (month) (year)
Degree Earned *
Cumulative GPA *
Major(s) *
Minor(s)
Campus and Community Service (Activities and offices held)
Extracurricular Activities (Honors, Awards, Honor Societies)

Graduate Institution #2 (if applicable)

School/University
School State
Start Date: (month) (year)
End Date (graduation, transfer, or expected date of graduation)*: (month) (year)
Degree Earned
Cumulative GPA
Major(s)
Minor(s)
Campus and Community Service (Activities and offices held)
Extracurricular Activities (Honors, Awards, Honor Societies)

Employment #1 (if applicable)

Company Name
Company City
Company State
Job Title
Start Date: (month) (year)
End Date: (month) (year)

Employment #2 (if applicable)

Company Name
Company City
Company State
Job Title
Start Date: (month) (year)
End Date: (month) (year)

Essay

Describe your contributions to the enhancement of fraternal ideals and discuss their application to your future career *: (less than 500 words)

Additional Materials

This application will not be considered complete until the following are supplied:

Your official transcript(s) from your college or university (photocopies and printouts are not official)
A graduate or professional school acceptance letter
A printed copy of this application, which will be provided upon successful submission

Mail these materials to:

North American Interfraternal Foundation
1750 Royalton Dr.
Carmel, IN 46032-9620

All materials must be postmarked by April 15. We will notify you if you have been selected to receive this scholarship by May 31.

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* = Required fields

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Lloyd Balfour Application

Instructions

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