Mother's Memorial Bible School Student Scholarship Application
This scholarship is for students attending a United Pentecostal Bible School
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Date of Birth
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Academic Information
Grade or Year Level
Latest GPA Score
Date Expected to Graduate
-
Month
-
Day
Year
Date
What are your goals for Bible School and after?
Education Information
Name of UPCI Bible School
Department
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Parental Information
If younger than 22
Name of Parents
First Name
Last Name
Address of Father
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address of Mother if different
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Church Information
Are you currently a member of a United Pentecostal Church?
Yes
NO
If yes, please list name of church and city.
Name of Pastor
First Name
Last Name
Address of Pastor
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please list your involvement in ministry in your local church.
Pastor's Recommendation Letter
Browse Files
Cancel
of
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Financial Information
Are you a dependent of your Parents?
Yes
No
Estimated Family's Joint Annual Income
Please Select
$0 to $19,400
$19,401 to $78,950
$78,951 to $168,400
$168,401 to $321,450
$321,451 to $408,200
$408,201 to $612,350
$612,351 or more
Have you tried applying for scholarships with other organizations previously?
Yes
No
Any information that might support your answer above
Have you tried applying for financial aid?
Yes
No
Any information that might support your answer above
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I AFFIRM THAT ALL STATEMENTS I HAVE INDICATED HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ANY MISREPRESENTATION I HAVE MADE CAN CAUSE FOR THE INVALIDATION OF MY APPLICATION AND SHALL BAR ME FROM RE-APPLYING FOR THE SAME.
Applicant's Signature
Name of Applicant
First Name
Last Name
Date Signed by Applicant
-
Month
-
Day
Year
Date
Submit
Should be Empty: