Jesus on Campus Scholarship Application Form

Jesus on Campus Scholarship Application Form
Name*

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Date of birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
University Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
FreshmanSophomoreJuniorSeniorHS Senior
Expected HS Graduation Date*

MonthDayYear
Date
Cumulative GPA*
Name of Scholarship*
Share a personal story about a time when you chose to live authentically despite challenges or when you demonstrated leadership in your community or on campus. If you are applying to both, please address both prompts. *
Essay (250-300 words)
Applicant's Declaration

I hereby declare that the information provided in this application is true and accurate to the best of my knowledge. I understand that any false information may result in the disqualification of my application.
Applicant's Signature*

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Date signed*

MonthDayYear
Date
Should be Empty: