University of Wisconsin Oshkosh

Silver Rose Freshman Scholarship

The Brothers of Omega Delta Phi Fraternity, Inc. at the University of Wisconsin
Oshkosh are proud to recognize scholastic excellence through our scholarship
awards. Through this award we hope to promote the ideals of higher learning and
continued education.

Qualifications

• Be a graduating male senior from a high school within the continental United States.
• Must be attending the University of Wisconsin Oshkosh in the Fall of 2010 as a full-time student.
• Complete and return the application postmarked no later than September 10th, 2010.

Instructions/Checklist
Transcripts
A transcript from the high school you recently graduated. You may also attach transcripts from other high
schools you have attended if you feel those transcripts will give Omega Delta Phi Fraternity, Inc. a better
understanding of your academic qualifications.

Personal Statement
Your personal statement should explain how one of the following characteristics applies to your life, goals, and
scholastic career: Unity, Honesty, Integrity or Leadership. The statement should not exceed two double-spaced
pages with 12 point font and one inch margins.

Honors, Extracurricular Activities, and Volunteer Work

On a separate sheet of paper, please list and describe any honors that you have received, extracurricular
activities, which you have participated, and any volunteer work that you may have done. You may also attach a
résumé.

Scholarship award will be awarded one time for amounts of $250.00

Scholarship finalist(s) may be required to conduct an interview at the request of Omega Delta Phi
Scholarship winner will be notified no later than September 24th, 2010

Completed applications should be mailed to

Omega Delta Phi –Reeve Union

748 Algoma Blvd
Oshkosh WI 54901.
 2010 Silver Rose Freshman Scholarship Application
Type or Print Clearly. If a question is not applicable, simply put N/A. Otherwise fill in all blanks.
Postmark Due Date: September 10th, 2010

Name: First M.I Last Ethnicity (Optional)

Address: Number & Street City, State Zip Code

( ) -
Telephone Number E-Mail Address

Date of Birth (Month/Day/Year) Place of Birth (City, State, Country)

Name of your High School Cumulative GPA (on a 4.0 scale) Class Rank

School Address: Number & Street City, State Zip Code

Financial Stament
Please use figures from your family’s 2009 Income Tax Returns

Parents or Legal Guardians’ combined gross income $_______________

Other Income (Specify) $_______________

Total Gross Income* $_______________

* If you feel this statement does not adequately reflect your family’s financial standing, please feel free to attach
an explanation of not more than one double-spaced page.

Certification Statement
I certify that all of the information on this form is true and accurate. I understand that I am required to be a full-time student at The
University of Wisconsin Oshkosh during the 2010-2011 academic year to receive funds. I certify that I will use any money I receive
from Omega Delta Phi Fraternity, Inc. for academic-related expenses only. I hereby certify that I have read this application and
certification and agree to all conditions.

X______________________________________ Date:__________________________________