Omicron Delta Kappa

National Leader of the Year Award Acceptance Form

Please review this form in detail before entering information. Many of the fields require documents that you must provide in order to submit this form. Your award package will not be complete until are required steps and documents are received.

O∆K seeks to be sensitive to gender neutral/gender inclusive pronouns. Please include your preferred pronouns for publications (e.g. he/him/his, she/her/hers, they/them/theirs, xe/xem/xyrs).
Provide a non-university email you are most likely to use for the next 3 years.
Please provide an address to which we can send the framed certificate and other documents as necessary.

The National Leader of the Year recognition is accompanied by a monetary award. The monetary award may be provided in one of three types. Please note that we cannot split the monetary award across two payment types.

Each payment type requires a different type of documentation. Once you have chosen and submitted this form, you will be provided with the instructions for the payment you have chosen. All awards will be distributed between July 1 and August 15, 2021. The payment type descriptions are:

Tuition Scholarship: A scholarship for graduate study will be paid to the institution for which you have enrolled. Scholarship payment may be deferred for up to three years.

Reimbursement for Educational Expenses: The Society will reimburse you for fees and supplies that directly support graduate/professional education (e.g., research fees, books, technology, software, etc., but not including expenses such as living expenses, professional travel, etc.). Reimbursement process where itemized receipts must be provided.

Cash payment: The Society will issue a check for the award amount directly to the award recipient. The recipient would be required to complete all the federal W-9 necessary paperwork for proper tax filing.

Please select only one. If you select the scholarship, please complete the Graduate School Information Section. If you select Reimbursement or Cash, skip to letters.
Please select an option. If you will be attending graduate/professional school later than Fall 2021 and you wish to defer, please select "Accept and Defer." You may defer up to three years with the payout being no later than June 30, 2023.
Graduate/Professional School Information
In this section, please provide all the information about your graduate/professional school if you are starting in fall 2021. If you defer, we will need this information at the time of enrollment.
Please upload a letter, official registration document, or a class schedule including a student ID number that verify you have been accepted and are enrolled in graduate/professional school. A letter of acceptance only is not acceptable.
Please provide the EXACT contact and address where your scholarship check should be mailed. Contact the institution's financial aid office to get the correct information. If O∆K does not receive the correct information, your scholarship may not be received by the school.
From the information provided by the Financial Aid Office, indicate to what office should the payment be made.
Thank You Letters
Please use the fields below to upload PDF or word versions of letters.
O∆K encourages scholarship recipients to thank those individuals who provided reference letters. Please indicate if you have sent thank you notes to your recommenders.
The funds for the Leader of the Year award are provided through generous donations. O∆K donors appreciate hearing from award recipients. Please write a letter that we can share with donors.
I hereby acknowledge and affirm that the information provided in this agreement is true and accurate to the best of my knowledge. I further accept the terms and conditions of the Leader of the Year Award. I agree that if I have fulfilled the necessary requirements for payment within one year of notification, the award funds shall be forfeit. I understand that I will maintain all other aspects of the award.
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