W.E.B. DuBois Honors Program
Application for the 2017 - 2018 Academic Year at
2016-2017 Academic Year
Application
for the 2015-2016
Huston-Tillotson
University
Honors Program
Huston-Tillotson's W.E.B. DuBois Honors Program
In recognition of your outstanding academic accomplishments during your high school
career, you are invited to apply for admission to the Huston-Tillotson University W.E.B.
DuBois Honors Program. Each year, approximately 20 new students will receive letters of
acceptance into the Honors Program. If accepted, you will be eligible for a tuition waiver
(covering your HT tuition and fees), and you will join the DuBois Scholars honor students
who participate in specialized honors courses, career oriented opportunities, service
projects and cultural enrichment events.
The goals of our Honors Program are as follows:
The
goals of our W.E.B. DuBois Honors Program are as follows:
To motivate academically gifted and talented students
To foster intellectual independence and the pursuit of academic excellence
To intensify the learning experience at Huston-Tillotson University
To prepare students for graduate schools and professional careers
To promote lifelong learning
Checklist:
Submitted a separate application for
Complete
application
admission
to DuBois
Huston-Tillotson
University
Attach writing sample
W.E.B. DuBois Honors Program
Attach high
school transcript
application,
completed
Letter of recommendation
Writing Sample, attached
Qualifications:
on higher
a 4.0 unweighted
scale
a.3.5
3.5G.P.A.
GPA or
on a 4.0 scale
b. SAT 1000 (Reading & Math)/ACT 22
Composite
Score,
22 or greater;
c.ACT
Examples
of your
leadership
ability
New
SAT
(SAT
taken
after
March
2016),
(via
and/or
community
activities)
Newschool
SAT (SAT
taken
after March
1, 2016),
1080 or greater (Combined Evidence Based Reading
andSubmit
Writinga&separate
Math); application for
Old SAT (SAT
taken before March 2016),
admission
to Huston-Tillotson
1000
or
greater
(Combined Critical
University
Reading & Math)
High School transcript, attached
Mail DuBois Honors application materials to:
Examples of your leadership ability
Two letters of recommendation,
(via school and/or community activities)
attached and/or forthcoming
Dr.
Janice
Sumler-Edmond,
Director
Mail W.E.B.
DuBois
Honors
ProgramDirector
application
materials to:
Ms.
Autumn
Caviness,
Mail
W.E.B.
DuBois
Honors
Program
application
materials to:
W.E.B.
DuBois
Honors
Program
Huston-Tillotson
University
W.E.B. DuBoisMs.
Honors
Program,
Huston-Tillotson
University
Autumn
Caviness,
Director
Ms. Autumn900
900
Chicon
Street
Chicon
Street
The Center for Academic
Excellence!,
Huston-Tillotson University
Austin,
TX
78702
900 Texas
Chicon78702
Street
Austin,
Austin, Texas 78702
Telephone: 512.505.3040
Telephone:
512-505-3100
Telephone:
512.505.3163
Email:
[email protected]
Email: [email protected]
Fax: 512: 505-3190
Austin,
Thank
Texas
78702
for
your
interest
in ourW.E.B.
W.E.B.DuBois
DuBois
HonorstoProgram!
Program!
Prospective
Scholar,
you
have
any
questions,
please
do
not hesitate
contact Ms. Caviness.
Thank
you ifyou
for
your
interest
in HT's
Honors
Email:
[email protected]
Telephone: 512.505.3040
Ms. Autumn Caviness, Director
The Center for900
Academic
Chicon Excellence
Street
Email: [email protected]
1
W.E.B. DuBois Honors Program
Huston-Tillotson University
Application for the 2017
2015-2016
- 2018 academic year
2016-2017
DEADLINE FOR
FOR RECEIPT
HONORS
APPLICATIONS
IS MAY
1, 2016
DEADLINE
RECEIPTOF
OF
HONORS
APPLICATION
IS JULY
1, 2017
Submit
yourapplication
application
by
2016
forearly
early acceptance
acceptance
consideration.
Submit
your
by February
March
1,15,
2017
for
consideration.
DEADLINE
FOR RECEIPT
OF HONORS
APPLICATIONS
IS JUNE
30, 2015
1. Personal Data (Please type or print neatly in ink.)
Name: _________________________________________________________________________
Address: _______________________________________________________________________
Street
City
State
Zip
Country
Telephone: _____________________________________________________________________
Home
Cellular
Email Address: __________________________________________________________________
Date of Birth: _______________________________ Age: _______________________________
Your gender: Male
Female
Mother's/Guardian's Name: ________________________________________________________
Occupation of Mother or Guardian: __________________________________________________
Father's/Guardian’s Name: _______________________________________________
Occupation of Father or Guardian: _______________________________________
Number of Brothers: ________________________ Number of Sisters: _____________________
2. Education Information (Please type or print neatly in ink.)
High School: ____________________________________________________________________
Address of High School: ___________________________________________________________
Size of Graduation Class: _________ Your Class Rank: __________ Graduation Date _________
Grade Point Average (GPA) [on a 4.0 scale] _________
SAT SCORES: Verbal ______ Math______ Writing ____ _ ACT SCORE: ______
Your Intended Major in College: _____________________________________________________
Your Intended Career: ____________________________________________________________
2
If you have taken Honors Courses or Advanced Placement Courses or if you have participated in
an accelerated program at your high school, list those courses or programs:
a.
c.
b.
d.
3. Telephone Interview (Please type.)
What are your preferred days of the week and times that we may call you for a telephone interview,
lasting approximately 15 minutes? We will telephone several days in advance to confirm the actual
day and time for the interview.
Mon
Tue
Wed
Thu
Fri
4. Interest Profile (Please type or print neatly in ink.)
List two or three memorable books you have read during the past two years:
a.
c.
b.
.
List your school activities:
a.
b.
c.
d.
List your community activities:
a.
c.
b.
d.
Which cultural events have you attended in the past two years? (Check all that apply.)
Play
Symphony or other musical concert
Dance Concert
Museum Exhibit
Vocal Concert
Other _________________________
5. Writing Sample
Write
an essay sheet
(approximately
two type-written
pages, double-spaced)
indicating
why you want
On a separate
of paper, write
an essay (approximately
two type-written
pages,
On a separate sheet of paper, write an essay (approximately one type-written page, double
to
become
a
Scholar
in
the
W.E.B.
DuBois
Honors
Program
at
Huston-Tillotson
University.
double-spaced)
whytoyou
wanta to
become
a Scholar
in the Honors
W.E.B. Program
DuBois at
spaced)
indicatingindicating
why you want
become
Scholar
in the
W.E.B. DuBois
Honors
Program
at
Huston-Tillotson
University.
In
your
essay,
(1)
link
your
academic
Huston-Tillotson University. Also discuss your academic qualifications that make you a good
In
your essay,
(1)
linkscholarship
your
academic
qualifications
to the
scholarship
ofupon
Dr. DuBois;
qualifications
the
of Dr.
W.E.B. DuBois;
and
(2) expound
why and
candidate
for theto
Honors
Program.
(2)
upon
why youfor
arethe
a good
candidate
for the W.E.B.
DuBois
Honors Program,
youexpound
are a good
candidate
W.E.B.
DuBois Honors
Program
at Huston-Tillotson
University.
here at Huston-Tillotson University.
3
Huston-Tillotson University----W.E.B. DuBois Honors Program
6. Teacher Recommendation Form
Student Applicant:
Please
Please complete
completethe
theblank
blankspaces
spaceson
onthis
thisform
formbefore
beforegiving
givingititto
tothe
theteacher
teacherwho
whowill
willrecommend
recommendyou.
The
teacher
may
send
this
completed
form
along
with
the
letter
of
recommendation
directly
to Ms.to
Caviness
you. The teacher may send this completed form along with the letter of recommendation directly
or
the
shared
applicant
may
include
the
teacher's
sealed
letter
and
form
in
his
or
her
application
packet:
Ms. Sumler-Edmond
Autu
Dr.
or the student applicant may include the teacher’s sealed letter and form in his
or her application packet. :
Dr. Janice
Sumler-Edmond,
Ms. Autumn
Caviness Director
W.E.B.
DuBois
HonorsProgram
Program
W.E.B.
DuBois
Honors
The
Center
for Academic
Excellence!
Huston-Tillotson
University
Huston-Tillotson University
900
Chicon
Texas 78702
78702
900 Chicon Street,
Street, Austin,
Austin, Texas
Phone: 512-505-3100
Phone:
512-505-3163
512.505.3040
Fax: 512-505-3190
Email:
Email:[email protected]
[email protected]
To the Teacher:
Your student, whose name is indicated below, is applying for admission to the W.E.B. DuBois
Honors Program. Our Honors Program is named for Dr. W.E.B. DuBois, the African American
sociologist, historian, writer, civil rights activist and intellectual of the twentieth century. Launched
during the fall semester of 2003, the Honors Program serves academically gifted and talented
students whose high school accomplishments are indicative of their intellectual ability, motivation,
and leadership ability. The program offers students scholarship assistance and a unique
opportunity to enrich their undergraduate education through specialized curricula, career-oriented
opportunities, service learning, and cultural activities.
Please assist us by indicating in your letter the student's qualifications for admission to our
Program, including his or her academic ability, level of maturity, and leadership potential.
APPLICANT'S NAME: ______________________________________________________
APPLICANT'S HIGH SCHOOL: _______________________________________________
RECOMMENDER'S NAME & TITLE: ___________________________________________
RECOMMENDER'S EMAIL OR PHONE________________________________________
To the Applicant:
In accordance with the Family Rights and Privacy Act of 1974, you may waive your right to inspect
this recommendation by signing the statement below. Should you decide not to waive your right,
you will have access to the recommendation if you become a member of the Honors Program.
I hereby waive my right of access to this recommendation.
I do not waive my right of access to this recommendation.
Applicant's Signature: _______________________________ Date _____________________
4