Southwest Region Conference

Union Scholarship Application

NOTE: CHILDREN OF EMPLOYEES ARE INELIGIBLE TO RECEIVE THE UNION SCHOLARSHIP

TO: Scholarship Applicant

RE:Southwest Region Scholarship Application

Enclosed please find the Southwest Region Conference Scholarship Application Form. Read the information carefully before completing this form.

Before you proceed to read the instructions and complete the application form, answer the following questions:

  1. Full Time Student at Southwestern Adventist University/Oakwood University – Undergraduate Studies ONLY:

Are you a full-time undergraduate student currently enrolled in Southwestern or Oakwood in a program leading to a Bachelor degree? Yes No

  1. Membership:

Are you a member in good and regular standing with membership in the Southwest Region Conference? Yes No

  1. Institution:

The college/university that I am attending is within the United States. Yes No

If you answered NO to any of the above questions, you are ineligible to receive the Southwest Region Conference Union Scholarship.

INSTRUCTIONS

Please read carefully the enclosed information and instruction. Completing all forms and obtaining the originalsignatures and financial records are essential to the application process.

The application form must be requested from the Southwest Region Conference Office of Education. No faxes or copies accepted – only originals.

A student can only apply for this scholarshipONCEa school year and must have successfully completed ONE semester prior to receipt of this scholarship. Funds will be posted to your account during the semester. Therefore, it is your responsibility to ensure that proper arrangements are made at the beginning of the semester.

The applicant must submit verification of financial need based on information included in the application, and must be earning satisfactory grades.

The application form needs to be completed and send to the Southwest Region Conference Office of Education.Applications received after the deadline will not be processed.

Deadline:

Fall Semester:July 31

Spring Semester: December 1

FAMILY STATUS:

NAME: ______AGE: ______SS# ______

STREET ADDRESS______

CITY: ______STATE: ______ZIP: ______

HOME NUMBER: ______CELL:______

ADDRESS WHILE AT SCHOOL:______

MARTIAL STATUS:SINGLE DIVORCED MARRIED SEPARATED:

SPOUSE’S NAME: ______

NUMBER OF CHILDREN: ______AGES: ______

CITIZENSHIP: ______

EDUCATIONAL STATUS:

NAME OF HIGH SCHOOL: ______

GRADUATION YEAR: ______

NAME OF COLLEGE/UNIVERSITY ATTENDING: ______

DATE STARTED: ______

ADDRESS:______

STREET CITY STATE ZIP

DEGREE SOUGHT: ______MAJOR AREA OF STUDIES:______

CLASSIFICATION: FRESHMAN SOPHOMORE JUNIOR SENIOR

SCHOLARSHIP IS REQUESTED FOR WHICH SCHOOL TERM:

SEMESTER: ______YEAR: 20__ __

WHICH SEMESTER DID YOU RECEIVED YOUR LAST SCHOLARSHIP:

SEMESTER:______YEAR: 20__ __

WHAT WAS THE VALUE OF THE SCHOLARSHIP RECEIVED: $______

FINANCES:

Please attached an original print out from the financial aid department of your institution that reflects your payment and balances of the prior semester that you were in school. (REQUIRED DOCUMENT) Applications will not be processed without the correct documentation.

Please submit supporting documentation

CURRENT MONTHLY BUDGET (Please calculate the figures below on a monthly basis).

MONTHLY INCOME / MONTHLY EXPENSE
Savings & Checking Accts. / *Tuition
Aid: (Parent(s) Guardian (s) / Fees
Applicant’s Income / Insurance
Spouse’s Income / Sub –Total - Monthly / $
GI Benefits / Tithe & Offerings
Work Study Assistance / Food
Other Income From: / Lodging
Sub-Total Monthly / $ / Creditor Bal:
Grants / Creditor Bal:
Loans
Scholarships
Sub-Total – Monthly / $ / Sub-Total Monthly / $
Grand Total - Monthly / $ / Grand– Total Monthly / $
  • If your tuition expense is on a quarterly basis, multiply the amount by 4, and then divide the total into 12, that would be your monthly expense. For example, if you pay 833.00 a quarter for tuition, multiply 833.00 x 4 = 3,332/12 = 277.67 (this would be your monthly expense). If your tuition fee is every 10 months, divide the amount into 10, the total is your monthly expense.

SIGNATURES:

ONLY SIGNATURES FROM THE APPLICANT AND THE LOCAL PASTOR AREACCEPTABLE. APPLICATIONS WITH AUTHORIZED SIGNATURE FROM THE PASTOR OR STUDENT BEHALF WILL BE DISQUALIFIED.



APPLICANT:

Affirmation: (Print Name) I, ______hereby state that the information given on this application is to the best of my knowledge true and accurate. I hereby indicate my loyalty to the principles of the Seventh–day Adventist Church and my commitment to its objectives. It is my plan to support the cause of God through the use of my training.

Date: ______Signature: ______

Applicant



CHURCH:

The ______SDA church of ______

approves the applicant as a member in regular standing and worthy of the scholarship grant requested.

Pastor’s Phone Number: (Day): ______(Evening): ______

Print Name: ______Date: ______

Signature:______

Pastor



LOCAL CONFERENCE:

The SOUTHWEST REGION CONFERENCE approves the applicant worthy of the Southwest Region Conference Union Scholarship.

Signature: ______Date: ______

The Southwest Region Conference denies this scholarship request for the following reason (s):

______Incomplete application

______Applicant is not a Seventh-day Adventist

______Late application (Funds depleted for the year)

______Authenticity of signature

______College/University is ineligible

______Missing financial records

______Other

______

Signature: ______Date: ______

Revised 7/2013

S. Ramsarran-Edu. Supt.