Estelle Beaumont Ellison Scholarship Fund Christ Episcopal Church Application Form

Transcription

1 The Estelle Beaumont Ellison Scholarship Fund at was created as an endowment fund, the income from which is to be given in the form of scholarships to worthy and deserving young men and women who will attend an accredited educational institution, or Episcopal seminary. The gift of the scholarship is an expression of the faith and commitment of the donor, Estelle Beaumont Ellison, who was a member of. Her gift is an expression of her faith in Jesus Christ as her Lord, in the parish of in its mission as God s church in this world, and in the potential of Christian young men and women. Her joyful expectation was that her gift be a positive influence in the world when, through it, young people are educated, trained and individually committed to contribute to the world in the name of Jesus Christ. The criteria for consideration are moral character, academic excellence (no minimum grades or test scores are required personal motivation is recognized as equally important as grades), financial need, and regular participation in the Christian community. Applicants must be residents of Bexar County, and be full-time students. Seminary applicants must be canonically resident in the Diocese of West Texas and attending an Episcopal seminary in the United States. Applicants must be between 14 and 30 years of age, except for seminary applicants. Awards are for one year only, but an application for renewal is available. The attached form is to be completed by all applicants (except those applying for renewal). All information used in evaluating the application will be inaccessible except to members of the Ellison Scholarship Committee, who will hold it in the strictest confidence. In an effort to ensure that the donor s wishes are carried out as completely and responsibly as possible, the Committee, which reviews all applications, asks that all applicants and their families sign below: I (we) certify and acknowledge that the Ellison Scholarship Committee of Christ Episcopal Church shall have the authority and permission to obtain any information it deems necessary from administrative officials at schools I have attended or plan to attend; that the Committee s recommendations will be submitted to the Vestry of, which has the sole authority to award funds; that any irregularities found in this application, or change in circumstances occurring after submission of this application (such as change of school, failure to maintain grades, etc.) may result in the re-evaluation, revocation, and/or withdrawal of any scholarship previously awarded, at the sole discretion of the Scholarship Committee; that the statements made in this application are true and correct to the best of my (our) knowledge and belief; that in the event of a change in circumstances after the date of submission of the application, I (we) agree to submit a supplement to the application containing information on the change in circumstances. Signature(s) of Parents(s) or Legal Guardian 1 Signature of Applicant Date

2 Last Name First M. I. Address (Permanent) Attach Required Photo Here City State Zip Permanent Telephone School/Cell Telephone Social Security # Date of Birth: Marital Status: Male/Female: address: Fax number (if available): FAMILY INFORMATION Father s Name Home/Business Telephone Address (city, state, zip) Occupation Mother s Name Home/Business Telephone Address (city, state, zip) Occupation 1. If your parents contribute toward your support, list: (a) the names and ages of all dependents and, if attending college more than half time, the college in which they are enrolled, and (b) list any elderly dependents. 2. If you are married, list the names and ages of your dependents, if any: 2

3 ACADEMIC INFORMATION High School(s) Attended: Graduation Date: GPA: College(s) Previously Attended Dates Cumulative GPA College Plans for Coming Year College Classification Major Expected Degree and Date of Graduation PERSONAL INFORMATION please attach an updated resume 1. Summarize any recent volunteer, church or community service work in which you have been involved. List any leadership position you have held, with approximate dates. 2. List membership in any college honorary, social, or professional organizations; include dates. List any other honors you have received. EMPLOYMENT INFORMATION 1. Did you work this past summer? If so, how much did you earn? What type of work did you do? 2. Do you intend to work next year? Type of work 3

4 FINANCIAL INFORMATION 1. Have you applied for an Ellison Scholarship in previous years? 2. Please list other types of financial aid (scholarships or grants) received last year. 3. Have you applied for and/or received any additional financial aid (student loans, grants, or scholarships) for the coming year? If so, please specify: 4. How much money have you already borrowed through the student loan program? Amount $ 5. If receiving support from parents, list the following, as shown on the 2005 Federal Tax Forms: Father s total annual income: Mother s total annual income: $ $ Additional annual family income: $ 6. List any other anticipated sources of income. (for example, personal savings, gifts, etc.) ANTICIPATED EXPENSES Tuition Required fees Books and supplies Room and board Travel and transportation Personal expenses Fraternity/Sorority TOTAL Explain any unusual expenses: 4

5 CHURCH INVOLVEMENT 1. Are you a member of? If not, what church do you belong to, or attend regularly? Address: _ Phone: Pastor/Rector/Youth Minister: 2. Describe your participation in the life of your church and your personal commitment to the work of Christ in the world: 5