Dell Scholars Program Application Worksheet

Funded by the Michael & Susan Dell Foundation (MSDF), a private foundation
dedicated to enabling children and youth to achieve their potential, the Dell
Scholars program offers an opportunity for under-served and lower income
students to realize their dream of a college education. $20,000 scholarships are
offered to students for full-time study to complete a bachelor's degree program.

The Dell Scholars Program places greater emphasis on your determination to

succeed than your academic record and test scores. We strongly believe being
adequately prepared for college also empowers you to achieve your dreams.

Criteria for Application

• Graduating from an accredited high school this academic year
• Earning a minimum of a 2.4 GPA
• Demonstrated need for financial assistance
• Participating in an approved college readiness program for a minimum of two years
• Planning to enter a bachelor's degree program at an accredited higher education institution in the fall of the
coming year immediately following High School graduation
• U.S. citizenship or permanent residency

Completing the application is the first step in becoming a Dell Scholar. Once submitted, all applications will be
assessed and a group of Dell Scholar Semifinalists will be selected. If you are selected as a semifinalist, you will be
asked to submit a current copy of your high school transcript, a complete Student Aid Report (SAR) from your
completed FAFSA, and a recommendation. Only semifinalists that submit this information will be considered for the
scholarship. After the semifinalist information is submitted, it is reviewed by an independent selection committee and
the Dell Scholars are selected. The new class of Dell Scholars will be announced April 10.

Contents
Contents ................................................................................................................................................................. 1
Important Dates ...................................................................................................................................................... 2
Things You Might Need.......................................................................................................................................... 2
Working on Your Application ......................................................................................................................................3
Hints for a Successful Application........................................................................................................................... 3
Application Sections ....................................................................................................................................................6
You ........................................................................................................................................................................ 6
School .................................................................................................................................................................... 8
Responsibility ....................................................................................................................................................... 11
Financial............................................................................................................................................................... 13
Home.................................................................................................................................................................... 14
Recommender ....................................................................................................................................................... 17
Terms ................................................................................................................................................................... 19

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Dell Scholars Program Application Worksheet

Important Dates
November 1 Application open to eligible students.

January 15 Application period ends.

February 1 Semifinalists are announced and the recommendation phase begins. Recommenders may log
into the website to complete recommendations for semifinalists. Applicants who become
semifinalists should upload their transcript(s) and Student Aid Report (SAR) by the deadline
below.

March 10 Deadline for submission of transcript, recommendation and SAR.

April 10 Announcement of New Class of Dell Scholars.

Things You Might Need

To help save time in completing the application, you may wish to gather the following information beforehand:
• The most recent federal tax return for your Parent or Guardian, if you are a dependent
• Your most recent federal tax return, if you file one
• Your high school transcript or report cards
• A unique email address that you check regularly

If you do not have all of the information listed, you may still begin your application and return later to complete any
missing information before the deadline.

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Working on Your Application

The application consists of the seven sections

• You
• School
• Responsibility
• Financial
• Home/Life
• Recommendation
• Terms

You may complete these sections in any

order you wish.

You may leave fields empty on these

pages and continue to other sections of
the application and come back later to
complete the empty fields. However, as
you leave each page, your answers will
be checked for errors, and you will be
required to correct any errors before
continuing to another page.

Once a section is determined to be

complete, a check mark will appear on
that section button in the navigation
menu. As you complete your
application, the menu will track your
progress. Unless noted as optional (by
the [opt] notation to the right of the
field), all fields are required.

As you go through each section, you

may want to refer to your high school
transcript or report cards to help you
answer the academic questions as well
as the most recent federal tax returns for
your Parent or Guardian, and you (if you
file one). Be sure to check out the Help Center for additional hints and answers to frequently asked questions.

You may leave the application using the ‘Log Out and Return Later’ link at the top of every page and you may return
later to work on your application until the deadline. All of the information that you have entered on a page and
submitted successfully will be saved and ready for you when you return.

Hints for a Successful Application

Having reviewed a large number of applications we offer you the following words of advice to consider while
completing your application.
• Don't use abbreviations or slang in your answers.
• Proofread your essays.

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Dell Scholars Program Application Worksheet

• Use the essays to tell the rest of the story that other questions don't ask. Talk about your responsibilities and
actions where possible.
• Choose a recommender that will be able to answer questions about you from a personal and academic
perspective.

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Dell Scholars Program Application Worksheet

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Application Sections
This section will walk you through each of the application sections in detail. Remember that it is in your best interest to
fill the application as completely as possible. If you prefer to answer on paper and then enter you answer into the
application, we have provided a blank ‘worksheet’ that you can use for this purpose.

You

Salutation Select the appropriate salutation. This is used in correspondence from MSDF. Options available:
(Required) Miss., Mr., Mrs., Ms.

Preferred Name What you like to be called. First name only. For example, if your name is James, your preferred
(Required) name might be ‘Jim’. We address correspondence using your preferred name.

First Name This is for your record and may be used to help identify you.
(Required)

Middle Name This is for your record.

(Optional)

Last Name This is for your record and may be used to help identify you.
(Required)

Suffix This is for your record and may be used to help identify you. A suffix on a name is something that
(Optional) comes after the formal last name such as Jr., Sr., III, etc.

Street Address This may be used to send physical material to you and for identification. There are two lines that you
(Required) can use for this if needed.

City This may be used to send physical material to you and for identification.
(Required)

State This may be used to send physical material to you and for identification. Options are available for all
(Required) states and Armed Forces US locations. Use ‘other’ if your State/location is not listed.

Zip/Postal Code This may be used to send physical material to you and for identification. We accept zip or zip + 4 in
(Required) addition to overseas postal codes.

Country This may be used to send physical material to you and for identification. If you are overseas, please
(Required) be sure to fill this out accurately.

Phone Number: Home (###) ### - #### This is the phone number in your permanent residence as detailed above. The
(Required) field will also accept international phone numbers if you are overseas.

Phone Number: Mobile (###) ### - #### This is a mobile phone number, if you have one. We would use this number if we
(Optional) were trying to speak with you over the phone and did not get an answer at your home phone. The
field will accept international numbers if you are overseas.

Gender Used for demographics purposes. Options available are Male, Female.

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(Required)

Date of Birth (Required) Used for eligibility purposes. You must be a graduating senior to be eligible for this scholarship.

Citizenship This scholarship is only available to US Citizens and Permanent Residents. Options available: US
(Required) Citizen, Permanent Resident, Other

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School

High School State, City, High School Name The data entry for this requires that you select these items in
(Required) order – First state, which then populates the city drop down box. Selection of the city populates
the High School box from which you select the school you attend.

Expected Graduation Month and Year that you expect to graduate.

(Required)

Class Rank Your ranking in your class. If your school does not rank students, check the box for "School
(Required) does not rank”. If you are unsure of what your rank and/or class size is, see your school
guidance counselor.

College Readiness Program You must be in an MSDF approved College Readiness Program in order to be eligible for this
(Required) scholarship. Applications will be verified with each program.

Program Advisor Name First and Last name of your program advisor. They may be contacted to verify your
(Required) participation.

Program Advisor Email Email address of your program advisor. Should be user@domainname.com. May be used to
(Required) contact your program advisor to verify participation.

Number of Years in Program How many years you have been participating in the College Readiness Program?
(Required)

Program learning’s essay How has this program better prepared you to be successful in college? Please provide some
(Required) examples of skills or strategies you will use. [100-1200 characters]
_____ on a ______ scale weighted/un-weighted
Cumulative Grade Point Fields to complete: GPA, Scale, Weighted/Un-weighted. Options for Scale are: 4.0, 5.0, and
Average (GPA) 100.0 weighted and un-weighted. If you are unsure of the scale your school is using, you can
(Required) ask your guidance counselor or college readiness program teacher. Select weighted if your
school gives additional point values for honors, AP, etc. courses. In the 100-Point Scale, the
grade average is determined by adding all earned marks, dividing that number by the total
number of points possible, and multiplying by 100. This scale is also known as the 100% Scale.
_____ on a ______ scale weighted/un-weighted
Grade 9 GPA Fields to complete: GPA, Scale, Weighted/Un-weighted. Options for Scale are: 4.0, 5.0, 100.0
(Required) weighted and un-weighted.
_____ on a ______ scale weighted/un-weighted
Grade 10 GPA Fields to complete: GPA, Scale, Weighted/Un-weighted. Options for Scale are: 4.0, 5.0, 100.0
(Required) weighted and un-weighted.
_____ on a ______ scale weighted/un-weighted
Grade 11 GPA Fields to complete: GPA, Scale, Weighted/Un-weighted. Options for Scale are: 4.0, 5.0, 100.0
(Required) weighted and un-weighted.

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Dell Scholars Program Application Worksheet

Critical Reading (Verbal) : _______ Mathematics: _______ Writing (If Taken): _______
SAT Scores If you have taken the SAT, please enter your scores. If you have taken the SAT more than
(Optional) once, enter your best score as a whole (not your best individual scores on portions).
English: _______ Mathematics: _______ Reading: _______ Science: _______ Writing (If Taken): _______
ACT Scores If you have taken the ACT, please enter your scores. If you have taken the ACT more than
(Optional) once, enter your best score as a whole (not your best individual scores on portions).
Course Name Status Grade Honors AP IB Dual Other
credit
English Grade 9
English Grade 10
English Grade 11
English Grade 12
Algebra 1
Geometry
Algebra 2
Trigonometry
Pre-Calculus
Calculus
Other Advanced Math
US History
World History
Government/Civics
Economics
World Culture/Global Studies
Geography
Psychology
Sociology
Foreign Language
Other Social Studies
Earth/General Science
Biology
Chemistry
Physics
Anatomy
Physiology
Computer Science
Other Science
If you have selected ‘Other’ as a type, please indicate what that type is:
Transcript Status and Grade are required entry for these fields. Options for status are: Not Taken, In
(Required) Progress and Completed. Options for grade are: A-F and n/a (not applicable). You would select
‘n/a’ if you did not take the course or if you took the course pass/fail and passed. If you are ‘in
progress’ for a course, estimate what your grade will be. If you have taken a course more than
once, enter the highest grade you received for the course.

Intended College Major What you are currently planning on majoring in college. You are not held to this for purposes of
(Required) the scholarship.

College Name Applied (yes/no)

1st choice
2nd choice
3rd choice
College Choices Funds from the Dell Scholars Program can only be used at accredited 2 and 4-year institutions.
(Required)

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College Selection Essay Required Please tell us what reasons you considered in selecting these schools as your top
choices.

Goals Essay Required What are your goals after you graduate college and how do you plan to achieve
them? 100-1200 character essay. What do you want to use your education to
achieve? Why is education an important part of your tools to achieve your
dreams? Will your goals require more than an undergraduate education? Is other
training required? If you want to be an astronaut someday, how do you plan on
getting there?

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Responsibility
This section helps us understand the different responsibilities and commitments you have during the school year and
over the summer. In your essays, please emphasize responsibilities you have rather than activities or involvement. Most
Dell Scholars have a high level of responsibility outside of school.

Use the essay space to provide important details about these parts of your life. What kind of responsibilities do or did
you have? What volunteer activities do you perform? Describe any leadership roles you performed. Focus on how you
helped others. Include important details that might help distinguish you from other candidates.

Classification: Weeks Avg hours Weeks Avg Hours

Freshman
Sophomore
Junior
Senior
Use the space below to provide more detail about your family responsibilities and how that has impacted your ability to manage academic responsibilities.
[100-1200 characters]

Home Responsibilities How many hours do/did you spend helping your family with domestic responsibilities (e.g.,
(Required) preparing meals, taking care of siblings/relatives, performing household responsibilities)?

Classification: Weeks Avg hours Weeks Avg Hours

Freshman
Sophomore
Junior
Senior
Use the space below to provide more detail about your community volunteer work. [100-1200 characters]

Community Volunteer Work How many hours do/did you spend volunteering (without pay) in your community (e.g., church,
(Required) community center, senior center, etc.)?

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Classification: Weeks Avg hours Weeks Avg Hours

Freshman
Sophomore
Junior
Senior
Use the space below to provide more detail about your need to work or information about why you do or do not work. If working, how has that impacted your
ability to manage school responsibilities? [100-1200 characters]

Work (Required) How many hours do/did you spend at work for pay outside of your home?

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Financial
The information on this page helps us determine your level of financial need. Completion of the Free Application for
Federal Student Aid (FAFSA) and receipt of a Student Aid Report (SAR) are required to receive this scholarship.

Parent’s Adjusted Gross Enter adjusted gross income from their most recent tax return. If no tax return was filed, enter
Income (Required) the amount that was earned in the last year.

Your Adjusted Gross Income Enter adjusted gross income from your most recent tax return. If no tax return was filed, enter
(Required) the amount that was earned in the last year.

National School Lunch Program (NSLP) Yes ______ No ______

Food Stamps/EBT or other food assistance program Yes ______ No ______
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Yes ______ No ______
Temporary Assistance to Needy Families (TANF) Yes ______ No ______
Low Income Home Energy Assistance Program (LIHEAP) or other utility assistance program Yes ______ No ______
Supplemental Security Income (SSI) Yes ______ No ______
Medicaid Yes ______ No ______
State / Federal Aid Eligibility Are you or your family ELIGIBLE or currently receiving any of the listed assistance programs.
(Required)

Student Aid Report Notification

I understand that if I am selected as a semifinalist, I will be required to submit a Student Aid Report (SAR) before the
semifinalist document deadline (March 10). I also understand that my financial need for the scholarship will primarily
be determined by my Pell Grant eligibility from my SAR.

You DO NOT need to submit your Student Aid Report at this time. For more information, visit www.fafsa.ed.gov.

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Home
This section provides us with information about your life at home and your parents.

Mother’s Marital Status Your mother’s current marital status. Options available for : Single, Married, Married to Father,
(Required) Re-Married, Divorced, Separated, Widowed, and Unknown.

Mother’s Education The highest level of education that your mother completed. Options available for: Did Not
(Required) Attend School, Elementary School, Middle School, Some High School, High School Graduate,
Some College, Associates Degree, College Graduate, Master’s Degree, Ph.D., I don’t know.

Mother’s Employment Status Options available: Employed Full Time (list occupation), Employed Part Time (list occupation),
(Required) Not Employed (seeking employment), Not Employed (homemaker), Not Employed (retired),
Not Employed (disabled), Not Applicable (deceased), Not Applicable (unknown).

Father’s Marital Status Your father’s current marital status. Options available for: Single, Married, Married to Mother,
(Required) Re-Married, Divorced, Separated, Widowed, and Unknown.

Father’s Education The highest level of education that your father completed. Options available for: Did Not
(Required) Attend School, Elementary School, Middle School, Some High School, High School Graduate,
Some College, Associates Degree, College Graduate, Master’s Degree, Ph.D., I don’t know.

Father’s Employment Status Options available: Employed Full Time (list occupation), Employed Part Time (list occupation),
(Required) Not Employed (seeking employment), Not Employed (homemaker), Not Employed (retired),
Not Employed (disabled), Not Applicable (deceased), Not Applicable (unknown)

Number of Family Members The number of people that will be supported by your parents. Include parents, yourself and
(Required) any other child in the family that meets the dependency criteria.

Family Members in College The number of dependents in your family that will be attending college at least half time in a
(Required) program that leads to a degree or certification. Include yourself in the count.

Residents in Your Home The number of people living in your home. Includes family and non-family members. Include
(Required) yourself in the count.

Mother ____ Spouse ____

Father ____ My child(ren) ____
Step Parent(s) ____ Friend(s) ____
Brother(s)/Sister(s) ____ I live in a group home ____
Grandparents(s) ____ I live on my own ____
Foster family ____ I do not have a home ____
Other Relatives ____ Other ________________________
________________________
________
You currently live with Indicate the number of each type of person that lives in the same primary residence with you.
(Required)

Primary Language Spoken at The language that is most commonly spoken at your home between relatives. The first
Home (Required) language that you learned.

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Family History (Required) Describe how your family history and relationships have shaped who you are today. [100-1200
characters]

Adversity (Required) Explain any adversities or hardships you have had to overcome and what helped you to
overcome these challenges. [100-1200 characters]

Personal Statement Use this essay to give us more information about who you are and why you want to be a Dell
(Required) Scholar [100-1200 characters]

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Yes ___
No ___

Personal Character Have you ever been subjected to disciplinary action (such as probation, suspension, or dismissal) by
(Required) any school you have attended? Have you ever been convicted of, or have charges pending for, a
misdemeanor or criminal offense? If yes, please explain. Note that a positive response does not
automatically exclude applicants from consideration.

Ethnicity (Optional) This question is not included in the evaluation process but is helpful to the Dell Scholars Program in
evaluating the composition of our applicant pool. The information you provide will be kept
confidential. Options available: American Indian or Alaska native, Arabic, Asian/Asian American,
South Asian (Indian subcontinent), Black or African American, Caucasian, Hispanic/Latino, Spanish
origin, Pacific Islander, Other (please specify). You may select more than one if appropriate.

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Recommender
All applicants who are selected as semifinalists are required to have a completed recommendation to be considered.
Your recommender must be at least 21 years of age and must not be related to you.

A recommendation consists of a number of essays and some questions that are similar to the application to provide
another perspective on you that can be used to ensure we select the most qualified candidates to be Dell Scholars. If you
are selected as a semifinalist for the Dell Scholars Program scholarship, the person listed below will be contacted in
order to provide a recommendation for you.

The recommendation must be completed online by your recommender. Remember that a completed recommendation is
required to be considered for a scholarship. Please ensure that the information you provide below is correct.

Salutation Select the appropriate salutation. This is used in correspondence from MSDF. Options available:
(Required) Dr., Miss., Mr., Mrs., Ms.

First Name This is for your record and may be used to help identify your recommender.
(Required)

Middle Name This is for your record.

(Optional)

Last Name This is for your record and may be used to help identify your recommender.
(Required)

Suffix This is for your record and may be used to help identify your recommender. A suffix on a name is
(Optional) something that comes after the formal last name such as Jr., Sr., III, etc.

Street Address This may be used to send physical material to your recommender and for identification. There are
(Required) two lines that you can use for this if needed.

City This may be used to send physical material to your recommender and for identification.
(Required)

State This may be used to send physical material to your recommender and for identification. Options
(Required) available for all states and Armed Forces US locations. Use ‘other’ if the State/location is not
listed.

Zip/Postal Code This may be used to send physical material to your recommender and for identification. We
(Required) accept zip or zip + 4 in addition to overseas postal codes.

Country This may be used to send physical material to your recommender and for identification. If you are
(Required) overseas, please be sure to fill this out accurately.

Phone Number A phone number where your recommender can be reached if necessary
(Required)

Email Address Used for correspondence and your record.

(Required)

Employer Where your Recommender works.

(Required)

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Position/Title What your recommender does at their place of employment.

(Required)

Relationship to You How do you know your recommender? Options available: School Teacher, School Counselor,
(Required) School (other official), College Readiness Advisor, Personal Mentor, Clergy (Minister, Pastor,
Rabbi, Imam, etc.), Friend of the Family

Years Known Options available: Less than 1 year, 1-2 years, 2-5 years, 5-10 years, more than 10 years.
(Required)

The recommendation provides a considerable impact on your application. Be very thoughtful about selecting who will
be your recommender.

Note that the best recommendations come from someone who can provide both personal and academic
information about you. A more thorough recommendation from someone such as a teacher, counselor, or
college readiness coordinator will give the selection committee more complete information typically than a
recommendation from a family friend.

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Terms
The last section of the application will require that you (and your parent if you are not 18) accept the terms of the
scholarship.

To review the current Dell Scholars Program Application Terms, log in to the application and click on ‘Help Center’ in
the top navigation. You will find a link to the terms in the Application Information section at the bottom of the page.

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