Kingswood Scholarship Application Form
Kingswood United Methodist Church | 401 W. Dundee Rd. Buffalo Grove, IL 60089 | 847-398-0770 | jpreston@kingswoodumc.com
Personal Data
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Parent/Guardian 1
First Name
Last Name
Parent/Guardian 1 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian 2
First Name
Last Name
Parent/Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Siblings Names and Dates of Birth
Member or Associated with Kingswood since? (Please indicate month and year)
Education Data
High School Attended
Graduation Date (Mo/Yr)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Post--Secondary School for Which Scholarship is Requested
Phone Number of Post-Secondary School
Please enter a valid phone number.
Address of Post-Secondary School
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Anticipated Graduation Date
-
Month
-
Day
Year
Date
Major Field of Study
Full-Time/Part-Time
Full-Time
Part-Time
Career Goal
Church, School, Community, and Work Involvement
Church Involvement: List all church activities in which you have actively participated. Please include the years in which you participated in these activities.
School and Community Activities: List all school and community activities in which you have participated during the past 4 years.
Work Experience. Describe your work experience during the past 4 years. Please include the length of time in which you worked there in addition to the hours you worked per week.
Attachment A - Essay for First Time Applicants
A two-part essay is required with your scholarship application. The topics for first time applicants are different than for previous applicants – please select the correct topic. Each part should consist of 250 - 600 words (1 – 2.5 pages double spaced). Please label each part. Essay topics: 1. “What Kingswood Means to Me”. 2. “What I Plan to do with My Education”.
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Attachment B - Essay for Continuing Students
A two-part essay is required with your scholarship application. The topics for first time applicants are different than for previous applicants – please select the correct topic. Each part should consist of 250 - 600 words (or 1 – 2.5 pages double spaced). Please label each part. Essay topics: 1. “How my faith helped my Academic Journey this year”. 2. “What I learned about myself this past semester”.
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References
Provide the following information for people you have asked to submit a letter of reference. Please include one adult non-family member and one from a current instructor. Please send the Kingswood UMC Reference form (https://form.jotform.com/223475129236053), which includes instructions, for your reference to upload and submit.
Name
First Name
Last Name
Occupation
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Instructor's Name
First Name
Last Name
Area of Teaching
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Transcript Information
Currently enrolled post-secondary students must include an official transcript of grades from all institutions attended dated within the past year. High School seniors or students who have completed less than one full semester of post-secondary education must include a high school transcript.
Applicant Rank/Class Size
Cumulative GPA (A=4.0)
Picture
Please upload a recent picture (preferably a graduation picture) for publicity purposes.
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Certification
In submitting this application, I certify that the information provided is complete and accurate to the best of my knowledge. Falsification of information may result in termination of any scholarship eligibility. I also agree that if I do not use the scholarship for the above-mentioned education, I will repay the scholarship in full to the appropriate scholarship fund.
Signature
Today's Date
-
Month
-
Day
Year
Date
Other Forms
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