Scholarship Application

First & Last Name *

First

Last

Scholarship limit is $500
Home Address *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *
Email Address
Parents/Guardians Name *
High School Graduation Date *
GPA *
Number of Children in Your Family Attending Post-Secondary School *
List Extra-Curricular Activities, Honor and/or Awards You Received in High School (You may attach additional paper if necessary) *
Check here if you upload addition files below.

Files Uploaded
File Upload (for additional extra-curricular activities submitted)
Select File(s)
PDF Files under 2 MB Only
Name of School You Will Attend *
Reasons for Selecting This School *
Intended Major *
When Do You Expect to Complete College? *
Briefly State Your General Education Plans and Ambitions *
What are your work experiences? *
How do you meet the Church's Mission Statement? *
Financial Information
Average Annual Educational Expenses

Please provide an average amount expected for a school year.
Tuition & Fees $ *
Room & Board $ *
Books $ *
Travel $ *
Miscellaneous $ *
Total Average Annual Education Expenses (total all above) $ *

This form does not total automatically, please enter the total.
Scholarship Grant Requested (Limit $500) *

Please tell us what amount of scholarship grant you are requesting.
Please list any extenuating circumstances we should know about.
I DECLARE THAT THE INFORMATION REPORTED ON THIS STATEMENT, TO BE THE BEST OF MY KNOWLEDGE AND BELIEF, IS TRUE AND COMPLETE.
Date *

mm/dd/yy

Financial Information