Kerr-Munson Scholarship Form

Kerr-Munson Scholarship Application Form
The primary purpose of this scholarship program is to support education (female students) and pre-medicine (male and female students) majors, primarily at Austin College, with funding for students at Trinity University, should funding be available.

The scholarship is multi-year, up to $5000 per year, with a maximum of $20,000 for four years.

The following criteria must be met by each applicant:
- You must be enrolled at Austin College or Trinity University.
- A female applicant must be in pursuit of a major in education or pre-medicine (or their equivalents). A male applicant must be in pursuit of a major in pre-medicine (or its equivalents).
- An applicant must be a member in good standing of a Presbyterian Church (U.S.A) congregation, as determined by the Synod Grants and Scholarship Commission.
There are additional requirements for application. Please go to: synodsun.org/kerr-munson for more information
Personal Information
Full Name*

First NameLast Name
Gender*

MaleFemaleNon-Binary
Birthdate:*

MonthDayYear
Age*
Preferred Mailing Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Preferred Phone Number*

Area CodePhone Number
Home Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
E-mail Address*
Where the confirmation will be send to
Did you receive this scholarship last year?*

YesNo
What college/university affiliated with the Synod of the Sun will you be attending?
What major will you pursue?
Where will you live while attending college?
Projected Graduation Date*

MonthDayYear
What year of study are you currently in?
Are you a US citizen?*

YesNo
If not a US citizen, what is your visa classification?
Marital Status
If married, will your spouse be a student?

YesNo
If yes, where?
Number of children that will be living with you
Ages?
Church Information
Are you a member of a PC(USA) congregation?

YesNo
Home Church
Pastor's Name

First NameLast Name
Home Church Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Income Estimates
What is your household income?
Dollars
Do you plan on working during the school year?

YesNo
Comments
Financial Information
Applicants are NOT required to submit a completed Free Application for Federal Student Aid (FAFSA) form. However, some of the questions listed below can be answered from your FAFSA form. You will want to have that form in hand when completing the next section.
Student's Adjusted Gross Income*
Dollars
Student's Income Earned from Work*
Dollars
Spouse's Income Earned from Work
Dollars
Student's Total of Cash, Savings and Checking Accounts*
Dollars
Student's Net Worth of Current Investments*
Dollars
What will be your income for the academic year Sep 2020 through Aug 2021?*
Dollars
Other Support Sources*
Dollars
What will be your expenses for the academic year Sep 2020 through Aug 2021?*
Dollars
If your expenses will exceed your income, describe how you plan to make up the difference.
Other Support Source Estimates
My family
Dollars
Type a Likelihood of this support coming in?

GuaranteedPossibleProbable
My Church
Dollars
Type a Likelihood of this support coming in?

GuaranteedPossibleProbable
My Presbytery
Dollars
Type a Likelihood of this support coming in?

GuaranteedPossibleProbable
Type a Likelihood of this support coming in?

GuaranteedPossibleProbable
Tuition Assistance from your college/university
Dollars
Type a Likelihood of this support coming in?

GuaranteedPossibleProbable
Other
Dollars
Type a Likelihood of this support coming in?

GuaranteedPossibleProbable
Comments
Expense Estimates

ONLY INCLUDE THOSE BEING PAID DURING SCHOOL YEAR. You may refer to your seminary's financial aid guidelines for budgeted expenses. Please provide your estimates of these expense items for the FULL SCHOOL YEAR (or for your term of study, e.g. one semester, if not enrolling for a full year.)
Tuition
Dollars
Books
Dollars
Rent / Mortgage
Dollars
Utilities (include all phones)
Dollars
Board / Food
Dollars
Transportation
Dollars
Uninsured Medical Expense
Dollars
Other Insurance Premiums
Dollars
Charitable Contributions
Dollars
Clothing
Dollars
Childcare
Dollars
Educational Loan Payments
Dollars
Outstanding Debit

DO NOT include amounts listed above
Credit Card
Dollars
Auto Loan
Dollars
Education Loans
Dollars
Other Debt
Dollars
Comments
Please explain any special circumstances or needs you have relative to this application:
By checking, you are submitting an electronic signature that all information you have included is truthful to the best of your knowledge.

Yes
Should be Empty:

Kerr-Munson Scholarship Application Form

Personal Information

Church Information

Income Estimates

Financial Information

Other Support Source Estimates

Expense Estimates

Outstanding Debit