IMPACT SCHOLARSHIP
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1 IMPACT SCHOLARSHIP SOUTHWESTERN BAPTIST THEOLOGICAL SEMINARY Please check, or highlight, all the following Impact Scholarship you would like to apply for (2 limit): Archeology Biblical Counseling Chaplaincy College at Southwestern Ministry Team (Husband and Wife Students) Christian Education Studies Campus Employees Scholarship Ethics Studies Women's Student Scholarship Disabled Student Scholarship International Student Scholarship Minority Student Scholarship Preaching and Pastoral Studies By State The Impact Scholarships are merit based scholarships provided to currently enrolled students primarily on the basis of the competitiveness of their application. It is not possible for Southwestern to provide for the total budget needs of students. Any assistance which can be provided by the Office of Financial Aid is supplemental to other income which a student may receive from employment, church and/or denominational support. Therefore, students are expected to relinquish the Scholarship when their tuition is provided by other sources. OFFICE OF FINANCIAL AID Post Office Box I Fort Worth, Texas I TEL ext I FAX I financialaid@swbts.edu
2 Please complete all information in the space provided. I. Personal Information Student ID: First Name: Last Name: Address: City: State: Zip: Home Phone: ( ) - Phone: ( ) - II. Family Information Current Marital Status (circle or highlight one) Single Married Divorced Separated Widowed Have you ever been divorced? Yes Spouse Name: Please list names and ages of children III. Citizenship Information Place of Birth City: State: Date of Birth: Country of Origin: Citizenship: Visa: Ethnicity 1 : Home City: Home State: Number of years in home city: If Texas, what county: Secondary home town/state: 1 Some donors established scholarships to be exclusive to certain ethnicities. To be considered for one of these scholarships, you may opt to provide this information. SWBTS does not discriminate on the basis of ethnicity in the award of scholarship funds.
3 IV. Church Information Name of church endorsing you to seminary: Address of that church: City: State: Zip: V. Military Information Have you ever served in the military? Yes If yes what branch? VI. Education Information Previous school(s) attended (please list school name, dates attended and degree earned): VII. Parental Information Is your parent(s) a missionary? Yes Is your parent on church staff? Yes If yes what position? VIII. Degree Being Pursued Campus Attending: Area of Concentration: Degree Currently Seeking: Hours Completed: Hours Currently Enrolled: Semester 1st Enrolled In Degree: Expected Graduation Date: Cumulative GPA: Expected Enrollment Fall: Expected Enrollment Spring: If Less Than 10 Hours Please Explain: If GPA below 2.5 what problems were encountered: Further Degree Desired at SWBTS: Yes/No What Degree:
4 IX. Church Related Ministry Information Name of Church Where Currently A Member: Is the Church Part of the SBC? Yes Present Staff Position: How long in present position? Present unpaid leadership role in your church Previous ministerial experience What are your future plans for ministry after graduation from seminary? Share your personal testimony and call to ministry. Provide significant contacts that may help you in ministry or area of large impact. Give names and addresses of three references, (if you are a current student please provide one professor or administrative staff person at Southwestern). X. Family Monthly Income Information Name of Employer: Name of 2nd Employer Name of Spouse's Employer: Monthly net income: Monthly net income: Monthly net income: Name of Spouse's 2nd Employer: Monthly net income: Monthly gift from church: Monthly gift from foundation: Monthly gift from family: Other monthly income: Total Monthly Income:
5 XI. Family Monthly Expense Information Tithe: Savings (monthly contribution): Rent: Mortgage: Does rent include utilities? Yes Health Insurance: Dental Insurance: If you do not have health insurance please indicate here: Auto Insurance: Groceries: Cell Phone: Laundry: Transportation: Credit Card Payments: OPC Payment: Recreation: Incidentals: Renters Insurance: Phone: Utilities: Clothing: Car Note: Educational Loans: Child Care: Prescriptions: Other: Total Monthly Expenses: Tuition and Fees per semester: Books per semester: School Supplies: Outstanding Debt (Total Amount due to creditor not monthly payment) Home Mortgage: Educational Loan: Car Note: Other Debt: Rental Land/Property: Credit Cards: Medical Bills: Other Debt:
6 XII. Personal Statement Please state briefly why you feel you should be considered for a scholarship, add any additional information you would like to provide, as well as your ministry plans.
7 XIII. Final Authorization I affirm the correctness of the submitted answers and, in the event a grant is made to me, I promise to use it for no other purpose that the necessary expenses of continuing my theological education. I certify that I have read and understand the terms and conditions of this grant, and I approve and accept the requirements contained in them: If a grant is made to me, I further promise: 1. To write a thank you letter to the scholarship donor if requested by the Office of Financial Aid; 2. To answer promptly all letters relating thereto, including correspondence with donors, if required; 3. To keep the Office of Financial Aid informed of my address and advised of the character of my work and my changes in remuneration affecting financial needs, as long as such information is needed; 4. In accepting this scholarship I agree to abide by all moral commitments of SWBTS and to be in chapel every day unless providentially hindered or have an agreement with the dean of Students based on unusual circumstances. 5. To attend the annual donor appreciation banquet if required; 6. To maintain records regarding awards received and actual payment of tuition and course related expenses in compliance with the current tax laws and IRS regulations. You may wish to contact the IRS or a tax advisor regarding the tax implications of your awards. In making this application for aid, I agree if aid is granted to devote my best efforts to the educational opportunity afforded by this aid. Signature: Date:
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