FRATERNAL ORDER OF POLICE ASSOCIATES

JOSEPH DENNIS SCHOLARSHIP FUND APPLICATION

PLEASE TYPE OR PRINT

Name: _____________________________________________________________________________________________________

Social Security Number: ______________________________________________________________________________________

Address: ___________________________________________________________________________________________________

Telephone: ______________________________________ Date of Birth: _____________________________________________ 

Qualifying Family Member: ___________________________________________________________________________________ 

Telephone: _________________________________________________________________________________________________ 

Father’s Name: ______________________________________________________________________________________________ 

Father’s Address: ____________________________________________________________________________________________ 

Mother’s Name: _____________________________________________________________________________________________ 

Mother’s Address: ___________________________________________________________________________________________ 

How many brothers and sisters do you have? ______________________________________________________________________

How many will be enrolled in college this fall? ____________________________________________________________________

What type of high school diploma are you seeking? ________________________________________________________________

What is your grade point average (G.P.A.)? _______________________________________________________________________

Number in class? _________________________________ Rank in Class? _____________________________________________

What college or university do you plan to attend? __________________________________________________________________

Have you applied for entrance? YES ( ) NO ( ) If so, have you been accepted? YES ( ) NO ( )

Please name the college(s)/university(s) to which you have been accepted: 

Have you been granted scholarship aid? YES ( ) NO ( ) If so, give details: 

Do you expect to receive scholarship aid from any other source? YES ( ) NO ( ) If so, give details: 

What full or part-time jobs have you had? List your employer(s) and date(s): 

ACTIVITIES/LEADERSHIP & SCHOLASTIC 

Honors and Awards:___________________________________________________________________________________________ 

Office(s) and Position(s) of Leadership (State name of organization, position and year): 

Member of Organization(s) where no office was held: 

List other activities: __________________________________________________________________________________________ 

Church Activities: ____________________________________________________________________________________________ 

Community/Volunteer: ________________________________________________________________________________________ 

Briefly summarize what made you apply for this scholarship. Use back of page or an additional page if necessary. 

In order to qualify for the Joseph Dennis Scholarship Fund, a student must meet one of the three 

following criteria: 

• Student is the child or grandchild of an active member in the Fraternal Order of Police Associates – 

Lodge #1 in Birmingham, Alabama. 

• Student is the child or grandchild of an active member in the Fraternal Order of Police – 

Lodge #1 in Birmingham, Alabama. 

• Student is the child or grandchild of an active member in the Fraternal Order of Police Associates/ 

Retirees– Lodge #1 in Birmingham, Alabama. 

SCHOLARSHIP CONDITIONS:

I agree that a transcript of my grades may be released to the Members of the Joseph Dennis Scholarship Fund Committee for the

Fraternal Order of Police Associates.

The Joseph Dennis Scholarship Fund will pay the college of the Recipient’s choice $500.00 toward tuition, on-campus room and

board, and books for each year of enrollment with a maximum of four (4) years enrollment in total.

Payments will only be made to an institution. The Recipient must mail a copy of the registration invoice to the Members of the

Scholarship Fund Committee, and prompt payment will be mailed to the university/college.

The Recipient must maintain a G.P.A. of at least 2.0 on a 4.0 scale (1.0 on a 3.0 scale) for the second year’s payment to be made. 

A copy of the Recipient’s grades must be submitted to the Members of the Scholarship Fund Committee for verification, along with

the current registration invoice before the second payment will be made. Subsequent years 3 and 4 will require the same conditions.

Should the Recipient fail to return to school for the second year (or any subsequent year) or fail to make the required grades, the

Members of the Scholarship Fund Committee reserve the right to hold any unspent portion of the Scholarship for use as it sees fit.

I, _________________________________________________________________________________________________________, 

have read and agree, if selected, to abide by the conditions stated above. 

Signature: ____________________________________________________________________________ Date: _________________