Scholarship Application

Please fill out completely. Only fully completed applications will be considered for approval.
Name

First NameLast Name
Birth Date

MonthDayYear
Date
Contact Information
2.Home Address: (all future correspondence will be sent to this address)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Cell Phone
Your Email Address
example@example.com
School Information
(Name of College)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What degree/occupation are your pursuing?
Family Information
Spouse Name & Occupation (Fill out if applicable)
Parent Names & Occupation
Siblings & Ages
Children & Ages (fill out if applicable)
Church/Faith Journey Information
Do you attend Allegheny Center Alliance Church?
*(Please note: Scholarships are intended only for applicants who are attending ACAC on a regular basis
How long have you attended Allegheny Center Alliance Church?
How often do/are you attend (involved) at ACAC?
In what ministries do you serve (volunteer) at the present time?
Please describe your salvation experience and describe your current spiritual journey.
Describe in detail how God led you to pursue this field and how you anticipate God using you in this area of work.
Education & Employment Information
Please list your work experience. (Dates, Business, and Type of Work)
Please list your education experience (Dates, School and Degree Obtained)
Academic Status: (please select what year of schooling your will be entering.)
Upload Current (Official/Unofficial) Transcript

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References
List three NON-FAMILY References. (Name, Phone Number, and Relationship)
Please communicate any special circumstances or issues you feel are not covered in the application
The information contained in this application is correct to the best of my knowledge. I, the undersigned, give my authorization to Allegheny Center Alliance Church or its representatives to contact my references as deemed necessary in order to verify this information. I understand that the personal information in this application will be held confidential by the Collegiate Scholarship Committee. By signing below, I agree to these terms.
Signature

Clear
Date

MonthDayYear
Date
Application Version August 2022
Should be Empty:

Contact Information

School Information

Family Information

Church/Faith Journey Information

Education & Employment Information

References