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CSA Disbursement Request

Please submit your chapter scholarship account (CSA) scholarship request(s) by filling out this form. Direct any questions or concerns you have regarding your request to fdnstaff@dcef.com or (463) 207-7234.

READ PRIOR TO SUBMITTING FORM:

  • Forms have to be submitted by a member of the ABT or a member of the chapter’s scholarship committee.
  • Do not include social security numbers on your submission.

PLEASE ALLOW AT LEAST 30 DAYS FOR US TO PROCESS YOUR REQUEST.

Name(Required)
Has the Scholarship Committee approved this request?(Required)
Is this a Chapter or Region scholarship request?(Required)
Semester/Quarter Type(Required)
Where should we send the scholarship check(s)?(Required)
**If you wish to have the scholarship checks sent to the individual scholarship recipients, please include those addresses in description textbox below (with their name & scholarship amount).
Mailing Recipient Name(Required)
This is the name of the person who will receive the mailed scholarships.
Mailing Address(Required)
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Drop files here or
Max. file size: 32 MB, Max. files: 4.
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    The Delta Chi Fraternity, Inc. ™ | 3845 N Meridian Street, Indianapolis, Indiana 46208
    (463)207-7200 | headquarters@deltachi.org

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