Joshua Berman Memorial SeriousFun Stipend Application

All SeriousFun stipend applicants must be an associate or Resident Council members of Phi Kappa Tau. Stipends awarded are intended for students who will be entering the next academic year as a sophomore, junior or senior. Applicants should have a GPA of 3.0 or higher and be enrolled as a full-time student.

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* 1. Contact Information:

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Chapter:

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* 3. I will enter the 2017-2018 academic year as a:

Sophomore

Junior

Senior

Graduate Student

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* 4. Projected Graduation Date:

Date / Time

Date

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* 5. Major:

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* 6. GPA:

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* 7. School Information:

Name

City/Town

State/Province

ZIP/Postal Code

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* 8. BOG Chairman Contact Information:

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 9. Chapter President Information:

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 10. Camp Name:

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* 11. Start Date of Service:

Date / Time

Date

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* 12. End Date of Service:

Date / Time

Date

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* 13. Supervisor Name:

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* 14. Supervisor Phone Number:

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* 15. Resume, which includes campus, community and volunteer activities:

PDF, DOCX, DOC file types only.

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* 16. Essay 1:

Describe and discus (1) how Phi Kappa Tau's partnership with SeriousFun Children's Network supports the mission, vision and creed and (2) how Phi Kappa Tau can increase its support of SeriousFun Children's Network at a local, regional and national level

PDF, DOCX, DOC file types only.

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* 17. Essay 2:

An essay describing your past experience of working or volunteering at a SeriousFun camp. How can this relate to your experience with Phi Kappa Tau? What moment has the biggest impact on you and why? What will you take away from this experience? How can this experience be used in your everyday life?

DOCX, DOC, JPEG, JPG, PDF, PNG file types only.

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* 18. BOG Recommendation Letter:

PDF, DOCX, DOC file types only.

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* 19. Dean/College Official Recommendation Letter:

PDF, DOCX, DOC file types only.

Choose File

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* 20. Please Certify the Following:

I will be enrolled in the 2017-18 academic year and will maintain my status as a member in good standing with Phi Kappa Tau and my college/university. If I fail to meet these requirements, I understand that I will be required to reimburse the Phi Kappa Tau Foundation for the full amount of the stipend.

I certify that all statements on this form and attached materials are true and correct to the best of my knowledge.