2023-2024 Peoples Church Book Grant Application

PEOPLES CONGREGATIONAL UNITED CHURCH OF CHRIST

4704 13th Street NW

Washington, DC 20011

scholarship@peopleschurchucc.org

(202)829-5511
2023-2024 BOOK GRANT APPLICATION
Please complete the information below. Book grant checks will be made payable and mailed to the applicant listed below. Checks are expected to be mailed to applicants in January 2024. APPLICATION AND ALL SUPPORTING MATERIALS ARE DUE BY FRIDAY, DECEMBER 8, 2023 AT 5:00 PM.
APPLICANT INFORMATION
Full Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicants Cell Phone Number*
Format: (000) 000-0000.
Applicant's E-mail
example@example.com
Applicant's Alternate Phone Number: blanks
Indicate type (home, parent's cell, etc.): blank
Make Check Payable to:
Address To Send Check:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
PARENT/GUARDIAN INFORMATION
Name

First NameLast Name
Cell Phone Number*
Format: (000) 000-0000.
E-mail
example@example.com
SCHOOL INFORMATION
Name of College/University/Post-Secondary School:
Anticipated Graduation Date (Month/Year):
Major
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
High School Name
High School Graduation Year
Applicants Cell Phone Number*
Format: (000) 000-0000.
Applicant's E-mail
example@example.com
ELIGIBILITY INFORMATION
YesNo
YesNo
If Yes, Indicate Scholarship (Year)
YesNo
If Yes, Indicate Book Grant Year(s):
UPLOAD SUPPORTING MATERIALS
Upload a copy of your Spring 2024 registration or other supporting materials that shows enrollment for Spring 2024.
File Upload*

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2023-2024 BOOK GRANT APPLICATION

APPLICANT INFORMATION

PARENT/GUARDIAN INFORMATION

SCHOOL INFORMATION

ELIGIBILITY INFORMATION

UPLOAD SUPPORTING MATERIALS

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