Kenny Kurtz Scholarship Application

Kenny Kurtz Scholarship Application

Correctional Ministries Institute, Wheaton College Billy Graham Center
ELIGIBILTY CRITERIA

Applicants must be:
- A Christian
- A U.S. Citizen
- Established in a local church
- Possess a high school diploma or GED
- Serving in Correctional Ministry
- Current Member of CMCA, Correctional Ministries and Chaplains Association
APPLICATIONS ACCEPTED: June 15 - August 15
PERSONAL DATA:

Tell us about yourself
Legal Name*

First NameMiddle NameLast NamePreferred first name
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile No. :*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Are you a US citizen?*

YesNo
What Certificate Program are you interested in?
EDUCATION:
Level of Education:
CORRECTIONAL MINISTRY:
Name of Ministry you currently serve with:*
Ministry Website: *
Describe your ministry title and involvement:*
Ministry Supervisor:

First NameLast Name
Ministry Supervisor Email:
example@example.com
Ministry Goals:
CHURCH/MINISTRY INVOLVEMENT:
Name of Church you presently attend*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Describe any ministry/volunteer involvement you have had at this church.*
AUTOBIOGRAPHICAL INFORMATION:
Have you accepted Jesus Christ as your person savior?
Statement of Faith: Describe your spiritual journey, coming to faith in Christ, and your current spiritual life.
Describe your calling to Correctional Ministry?
INCARCERATION INFORMATION:

(If applicable)
Statement of Incarceration: Describe your a) path to incarceration, b) illegal act(s), c) impact on victims and, d) how you have changed.
Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:*
Should be Empty:

Kenny Kurtz Scholarship Application

PERSONAL DATA:

EDUCATION:

CORRECTIONAL MINISTRY:

CHURCH/MINISTRY INVOLVEMENT:

AUTOBIOGRAPHICAL INFORMATION:

INCARCERATION INFORMATION:

Applicant's E-Signature