scolarshipTest

Scholarship Application

Application Deadline: May 15, 2015

Date *

Name *

Social Security # *

Permanent Address *

Birth Place *

Date of Birth *

Marital Status *

Single

Married

Phone *

Parents or Guardian Names (if living) *

Email *

School Address *

(if different from above)

Name of School *

(to be attended during scholarship)

Mailing Address of School *

Progress Towards Degree

Indicate your progress towards your degree by filling in one of the sections below (a, b, c or d).

a) Full-time undergraduate *

Junior

Senior

b) Part-time undergraduate - No. of Hours Completed *

Est. of Hrs. Required for Degree *

c) Full-time graduate - No. of years completed *

Years required for degree *

d) Part-time graduate - number of hrs. completed *

Est. of hrs. required for degree *

Undergraduate School *

(if graduate student)

Undergraduate Degree Attained *

Major *

Date *

Expected Degree *

Major *

Minor *

Expected Completion Date *

Therefore encourage one another and build up each other, as indeed you are doing. The grace of our Lord Jesus Christ be with you.