AMERICAN

DRUZE SOCIETY SCHOLARSHIP APPLICATION PART I: PROGRAM ENTRY APPLICATION Applicant Name: I have read and understand the conditions of the AMERICAN DRUZE SOCIETY NATIONAL SCHOLARSHIP PROGRAM as explained in the current Information Page. I understand that this application will be available only to members of the Selection Committee. I affirm the information contained herein is true and accurate to the best of my knowledge. Signature: Date: Legal Name: Last First M.I. Home Address: Street/ P.O. Box City State , Zip Country Home telephone: Email Address (please notify us of changes): Preferred Mailing Address If Different From Home: Street/ P.O. Box City State , Zip Country Have you ever applied for an ADS Scholarship? If yes, what year? Have you ever received an ADS Scholarship? If yes, what year?

 AMERICAN DRUZE SOCIETY SCHOLARSHIP APPLICATION PART II: INFORMATION AND ESSAYS Applicant Name: Please fill applicable section below. High School Applicant High School Name: Graduation Month: Year: Current Cumulative GPA: on a scale Estimated Rank and Class Size: / Undergraduate School Applicant College/University Name: Graduation Month: Year: Current Cumulative GPA: on a scale Credits Earned: Total Credits Required: Major: Minor/Concentration: Graduate School Applicant University Name: Graduation Month: Year: Current Cumulative GPA: on a scale Credits Earned: Total Credits Required: Major: Concentration:

 Candidates must answer all the following questions. 1. List all other secondary schools and higher education institutions you have attended. Include summer, studyabroad, exchange programs. Institution Location Dates Attended Degree Earned

2. Academic Honors and Other Distinctions: Please describe any scholastic distinctions and/or honors you have won, publications, or any other special recognitions. Include the year received.

 3. Extracurricular and Volunteer Activities (public service/community service): Activity Grade Level Description Position Held

 4.

Work Experience (Internships, parttime, and fulltime jobs): Title Employer Job Description Dates Average hours/week

 5. Additional Information: Please include any additional personal information you wish to share for the evaluation of your application. 6. Character References: Please list two people who are willing to serve as character references. Do not include any family. Name Relationship to Applicant Telephone Number

 7. Essay: Please choose one of the listed topics and compose an essay of 500 words. For prior year applicants, please pick a prompt that you have not previously selected. Congratulations! You have completed the ADS Scholarship application. We look forward to reviewing your application. Please email your application and all necessary attachments to Scholarship@Druze.com. You will be notified once your application has been received. REMINDER: Your application will not be considered complete until you have emailed the committee an unofficial transcript. If you could change one thing in the ADS, what would it be and why? How would you implement this change? As a young Druze adult living in two cultures, how do you preserve your Druze culture while balancing your American Culture? What role does the ADS play in your life, both your local chapter and the National ADS? In your opinion, what is the most important service the ADS provides to our community? How can the ADS best empower its youth to be active contributors and participants in our society/organization?