The Dillenkoffer Endowment

A scholarship for distinguished Kansas or Missouri high school students who are openly gay, lesbian, bisexual or transgendered and plan to attend a Kansas or Missouri college or university.

The Dillenkoffer Endowment is a four-year scholarship that will provide up to $10,000 annually for 4 years of tuition at a Kansas or Missouri college or university. Applicants must be a resident of Kansas or Missouri and have at least a 2.75 GPA.

Applicants will need to describe how they have made a difference through involvement in community and school activities. There are no restrictions or limitations in the selection procedures based upon gender, race, religion, or creed. Applications and transcripts must be postmarked or emailed between January 1, 2011 and March 15, 2011 for the 2011 fall semester, and applicants must be willing to travel to Kansas City on April 17, 2011 for formal interviews.

The Dillenkoffer Scholarship Selection Committee will announce the scholarship recipient on or about May 1, 2011.

ONLINE APPLICATION

First Name:
Middle Name:
Last Name:
Birth Date:	/ /
Complete Address:
City:
State:
Zip Code:
Phone:	( ) -
Cell Phone:	( ) -
E-Mail:
Alternate E-Mail:
Parent/Guardian 1:
Occupation:
Address (If Different):
Parent/Guardian 2:
Occupation:
Address (If Different):
I live with:
Number of children in your home:
Number of family members in college:
High School:
Address:
City:
State:
Zip Code:
High School Counselor:
Phone:	( ) -
Graduation Date:
Senior Awards Program Date & Time:
GPA:	on a Point Scale
Class Rank:	of
ACT or SAT composite:

1) What university do you plan to attend?
Have you been accepted?
If “NO”, please explain:
2) Apart from this scholarship, how do you plan to finance your education?
3) List school, community, and religious activities (if any) and duration of each activity.
4) List awards and/or honors and from whom.
5) List employment experience (if any).	EMPLOYER JOB HELD LENGTH OF TIME
6) List as references two adults who know you well and are not relatives.	Name Address Phone How do you know this person? Name Address Phone How do you know this person?
7) In paragraph form, state the reasons that you want to further your education and describe your career goals. Attach additional pages as necessary.
8) Describe your experiences as an openly GLBT student in your school; your experiences when and how you came out and the impact of your coming out on yourself, your family, your schoolmates, and community. Attach additional pages as necessary.
9) Explain what you consider to be the most important issues facing the GLBT community today. Attach additional pages as necessary.
10) Financial information: Attach a copy of your Student Aid Report (SAR) or FAFSA application.
11) List sources of financial assistance while attending college, with amounts:
12) Parents’ or Guardians’ combined income in the last calendar year:
13) Explanation of financial need:
14) Are your parent(s)/guardian(s) aware that you are applying for this scholarship?
If “NO”, please explain:
15) How did you find out about the Dillenkoffer Endowment?

APPLICANT CERTIFICATION

By my submission of this application to the Dillenkoffer Endowment Selection Committee, I certify I identify as being gay, lesbian, bisexual or transgendered; that if I am awarded a scholarship, the proceeds will be used for the payment of tuition, books, and fees at a Kansas or Missouri college or university; and that I will be enrolled full-time in a program that leads to a degree or professional certification.

I further certify that the information submitted on this application is complete and accurate to the best of my knowledge. I understand and agree with my responsibilities as detailed herein. If awarded a scholarship I understand that renewal requires academic progress, continuing service to the GLBT community and an annual interview with the scholarship committee.

CODE OF CONDUCT: I understand Dillenkoffer Endowment Scholarships are awarded to students with a reputation for honesty, integrity and community service. I understand that dishonesty, failure to keep in contact with the scholarship committee or actions which bring disrepute to recipients or to the scholarship program will subject me to sanctions up to and including removal from the scholarship program and termination of scholarship benefits.

To submit your application online,
please type your name and click the Submit button below:

Applications must be submitted and received by March 15, 2011.

Applicants must arrange for official high school transcripts to be received by March 15, 2011.

Mail or email official transcripts, questions or applications to:

The Dillenkoffer Endowment
10109 N. Lane Dr.
Kansas City, MO 64157-7863
866-465-2008
info@dillenkoffer.org

Applicants must be a resident of Kansas or Missouri and plan to attend a Kansas or Missouri college or university. Applicants are responsible to accomplish their own enrollment with their chosen university. There are no restrictions or limitations in the selection procedures based upon gender, race, religion, or creed.