AHEPA EDUCATIONAL FOUNDATION
JOURNEY TO GREECE

Application for Participation

I hereby apply for participation in the AHEPA Educational Foundation Journey to Greece. I have notified my AHEPA or Daughters of my application.

(Please print or type)
Name ______________________________________________________________________________

Address _____________________________________________________________________________

City ____________________________ State ___________________ Zip Code __________________

Home Phone __________________________ Email _______________________________________

Date of Birth __________________________ Place of Birth ________________________________

I am a student at _________________________________________ Grade: ____________________

Ability to speak Greek (please circle one): None Fair Good Fluent

CHECK ONE:

______ I am a member in good standing of Chapter No: of the Sons of Pericles or Maids of Athena
located in __________________________________________.

______ My father and/or mother - (circle one or both, if applicable) - is a member in good standing of _____ AHEPA or ___ Daughters of Penelope Chapter No. _____ Located in ________________________.

_______ I am not, nor are any of my immediate family members, members of the AHEPA Family.

Documents Required — Applications will not be considered if not accompanied by the following:
1. Certified copy of birth certificate.
2. Transcript of most recently completed school semester.
3. Confidential report from either the high school counselor or principle.
4. A letter giving your reasons for applying for this program. (See other side)
5. A recent photograph.
6. Full payment as outlined in cover letter.
7. Students must be a minimum age of 17 and in their last year of high school or within their first two years of college.

Date ______________________ Student’s Signature _____________________________

I have read “The AHPEA EDUCATIONAL FOUNDATION JOURNEY TO GREECE RULE AND REGULATIONS,” I hereby consent and agree to those rules and regulations, and I assume full personal responsibility for the actions of my son or daughter.
Signed: __________________________________
Parent or Legal Guardian
- Application deposit of $350.00 is to accompany the application form.
Make checks payable to: AHEPA Educational Foundation.
Mail with payment on or before Deadline to:
*AHEPA/Journey to Greece, 1909 Q. Street, NW, Suite 500 , Washington, DC, 2009, (202) 232-6300, ahepa@ahepa.org

DEADLINE: MAY 1, 2006