21' CI Bullock Scholarship Application

B. High School or College Information
Name used on School Records
Last, First, Middle
Name of High School/College
Street Address
City/State/Zip Code
C. Intended College/University Information
Name of College/University/Trade School
Street Address
City, State, Zip Code
Accepted

Y (Yes)N (No)
D. Recommendation/Reference Contact Information

Church Leader, High School/College Official, Supervisor/Mentor
Name
Type a question
Address

Street Address

Street Address Line 2

City, State Zip CodeState / Province

Postal / Zip Code
Name
Relationship
Address

Street Address

Street Address Line 2

City, State Zip CodeState / Province

Postal / Zip Code
Name
Relationship
Address

Street Address

Street Address Line 2

City, State Zip CodeState / Province

Postal / Zip Code
E. Essay

Please attach a double spaced, one page essay (size 12 font) about the experiences and opportunities that have influenced you the most, including those at the Memorial A. M.E. Zion Church.
F. Required Signatures
Student Applicant

Clear
Parent/Guardian

Clear
Completed applications must be received by APRIL 1, 2020

Applications will not be accepted after APRIL 1, 2020
Upload Attachments
1. Acceptance Letter

2. Essay

3. Official High School/College Transcript

4. Letters of Reccomendation (3)

5. Headshot Photo
Cancelof
Should be Empty:

A. Church & Community Involvement