PENDLETON LOAN APPLICATION FORM

UNDERGRADUATE STUDENTS

(NOTE: Incomplete applications will not be considered)

DUE DATES:Fall & Spring Semesters July 1 Fall Sem. Only July 1

Summer Semester Mar. 1Spring Sem. Only Oct. 1

I hereby apply for a Florence Pendleton Loan in the amount of $ to assist in my educational expenditures during the period beginning, and ending.

I graduated from Chillicothe High School on .

I intend to be full-time student, Part-time student.

Date Money Needed

EFC Number from Student Aid Report (from FAFSA)

PERSONAL INFORMATION

Student Name

Last First Middle (Maiden)

Permanent Home Address:

StreetCityStateZip(Phone)

Cell Phone:Email:

Age Date of Birth

Full Name of Spouse (if applicable)

FirstMiddleLast(Maiden)

Full Name of Parents or Guardians

AddressPhone

List the names and address of two persons, other than parents, who will always know your current address.

List two persons who will co-sign this loan for you (usually your parents)

EDUCATIONAL STATUS

Are you presently enrolled in or have you been admitted to school? (yes, no)

School Name

List schools you have attended since graduating from Chillicothe High School.

NAME OF SCHOOL DATES ATTENDED REASON FOR LEAVING

Major field of study

Minor field of study

Total hours completed to date

Expected completion date: Present Grade Point Average

PROPOSED BUDGET: Please list your estimated educational costs for the period covered by this loan request.

Tuition and Required Fees: $

Books, Instructional Materials, &

Equipment$

Room & Board (Rent) if applicable$

Other Expenses $

Other Expenses $

Other Expenses $

List all scholarships, grants, work study, and loans applied for:AWARDED

Yes No

CURRENT:

PAST:

Will you be receiving the John Deal Scholarship? _____

If so, list the dollar amount: $______

Will you be receiving the Bob & Helen Crabtree Scholarship? ______

If so, list the dollar amount: $______

List all other Student Loans currently held:

Amount of Loan $

Amount of Loan $

Amount of Loan $

List all other indebtedness, including source of loan, purpose, amount, and unpaid balance (including credit cards.)

CURRENT EMPLOYMENT

List current employment, name of employer, and business address.

Applicants are reminded that a Pendleton Loanbecomes a legal contract, the proper execution of which being very important to the applicant's reputation.

Certification:

I hereby acknowledge and affirm that the information submitted herein is true and correct.

DateApplicant's Signature

ADDITIONAL DOCUMENTATION NECESSARY TO COMPLETE THE APPLICATION PROCESS:

HIGH SCHOOL AND/OR COLLEGE TRANSCRIPT (most current)

COLLEGE AWARD LETTER

COPY OF FAFSA STUDENT AID REPORT (with EFC number)

PROOF OF ENROLLMENT FOR UPCOMING SEMESTER

______

Do Not Write Below This Line

EFC $______

Total Other Awards/School: $______

Projected graduation date ______

Current Cum GPA: ______

Addendum

TO

Pendleton Student Loan Application

4/21/99

Beginning with the 1999-2000 school year, loans will be considered for the following amounts:

Entire school year (2 regular semesters): $1,000, $2,000 or $3,000 per school year.

Individual semesters: $500, $1,000 or $1,500 per semester (not including summer sessions.)

Instructions and application follow this page.

PENDLETON STUDENT LOAN

INFORMATION AND INSTRUCTIONS

(UNDERGRADUATE STUDENTS)

  1. The Florence Pendleton Student Loan Fund was established by the estate of the late Florence Pendleton. The Fund was established to provide interest-free loans to financially needy graduates of Chillicothe High School who require the money in seeking post high school, college, or technical training. It would be a violation of Mrs. Pendleton’s wishes for a student to apply for this money if he/she can attend a school without it.
  1. It is expected that a student will apply for an use any other type of available funds or financial aid for which he/she is eligible. This is in the student’s best interest, because such awards as scholarships, Pell Grants, Missouri Grants, and money not borrowed do not have to be repaid. To show compliance with this provision, applicants are to send a copy of their Award Letter received from the Financial Aid office of the college attended with the loan application. Questions about this may be answered by College Financial Aid Officials and Guidance Counselors.
  1. Students must have a minimum cumulative grade point average of 2.5 on a 4.0 scale to be considered for a loan.
  1. Loan requests must be made by the appropriate deadlines. Deadlines are: JULY 1 for the entire school year, JULY 1 for Fall Semester only, OCTOBER 1 for the Spring Semester only, and MARCH 1 for the Summer Semester only.
    Application forms are available in the Chillicothe High School Guidance Office.
    (1)The Pendleton Loan Application form is to be returned to the Pendleton Executive Secretary, P.O. Box 545, Chillicothe, MO 64601
    (2)The applicant is also required to file a confidential financial statement of his/her choice, such as the FAFSA, with results to be sent to the Pendleton Trustees, P.O. Box 545, Chillicothe, MO 64601

The financial statement will help determine the financial need of a student for the requested loan. It will show the expected contribution toward the educational expenses by the family, both parents, and the student. This information will be used by the trustees in determining the amount of the loan to be granted. The information will be treated in strictest confidence.

(3)Students who have previously attended college are required to provide the Pendleton Trustees with a college transcript with each new request for a Pendleton Loan. Write the registrar’s office at the college(s) attended and ask that a transcript copy be sent to the Pendleton Trustees, P.O Box 545, Chillicothe, MO 64601

(4)The applicant shall also provide proof of enrollment for the semester(s) for which the loan funds are being requested. Borrowers must continue to provide proofs of enrollment for all future semesters to fulfill full-time attendance requirement, even if not requesting additional loan funds.

  1. Amounts of loans will be made to cover one academic school year or less. Maximum loan amounts will be limited to $3,000 annually. Loans will be considered for the following amounts: Entire school year (2 regular semesters): $1,000, $2,000 or $3,000 per school year, individual semesters: $500, $1,000, or $1,500 per semester (not including summer sessions.) The trustees reserve the right to approve loans in amounts other than those listed here. Applicants may apply for additional loans at any time the need arises even though previous loans have been made or denied. Yearly loans will be divided and paid to the student, half at the time of loan disbursal with the other half paid when needed for the second semester. Applicants must provide proof of enrollment for the second semester before loan funds will be disbursed for second semester.
  1. After approval, first-time borrowers and their co-makers (usually their parents), and their spouse (if applicable) must attend a Loan Informational Meeting. Terms of Pendleton loans will be discussed, and a time will be set aside for signing promissory notes and receiving the loan proceeds. Potential borrowers will be notified of their approval status, and the date and time of the signing session at which all signers need to be present. All students, co-makers and spouses must sign the promissory note form.

Pendleton Trust Address:

Pendleton Trust

P.O. Box 545

Chillicothe, MO 64601

Pendleton Loan Application Form, Revised 11-15-10