TEXAS-LOUISIANA GULF COAST
WOMEN OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA
EDUCATION SCHOLARSHIP APPLICATION FORM 2008
GENERAL INFORMATION
____________________________________________________________
Name (last) (first) (middle initial)
____________________________________________________________
Street Address Apt. #
____________________________________________________________
City State Zip
____________________________________________________________
Day Phone # Evening Phone #
____________________________________________________________
E-mail Fax
Age _______________________
Are you a United States Citizen? Yes____ No_____
Marital Status: _____Single _____Married
_____Widowed _____Divorced _____Separated
|
You must be a member of an Evangelical
Lutheran Church in America congregation.
____________________________________________________________
Name of ELCA Congregation
____________________________________________________________
Street Address
____________________________________________________________
City, State, Zip
Check if you wish
_____African American ______ Asian American
_____Native American/American Indian
_____Hispanic _____Caucasian __Other:__________
How many years since the completion of high
school? (Consecutive Years) ______________________
Ages of dependent children:________________
|
EDUCATIONAL BACKGROUND
List schools attended, starting with high school.
__________________________________________________________________________________________________________________________
Institution Diploma/Degree Year Degree Granted
Dates Attended
__________________________________________________________________________________________________________________________
Institution Diploma/Degree Year Degree Granted
Dates Attended
__________________________________________________________________________________________________________________________
Institution Diploma/Degree Year Degree Granted
Dates Attended
__________________________________________________________________________________________________________________________
Institution Diploma/Degree Year Degree Granted
Dates Attended
|
PROFESSIONAL OR OCCUPATIONAL BACKGROUND
List most recent position first.
__________________________________________________________________________________________________________________________
Employer Position Dates (mo/yr) Reason for Leaving
__________________________________________________________________________________________________________________________
Employer Position Dates (mo/yr) Reason for Leaving
__________________________________________________________________________________________________________________________
Employer Position Dates (mo/yr) Reason for Leaving
_________________________________________________________________________________________________________________________
Employer Position Dates (mo/yr) Reason for Leaving
|
|
PROPOSED PROGRAM
___________________________________________________________
Name of University or Institution
___________________________________________________________
Street Address
___________________________________________________________
City State Zip
___________________________________________________________
Program or Course of Study
____Undergraduate ____ Graduate _____Vocational
Starting date_______________________
Expected completion date____________________
|
Total cost of program$___________________
Amount requested from
Women of the ELCA $___________________
Other funding sources
___________________ $__________________
___________________ $__________________
___________________ $__________________
|
Have you previously received a Women of the ELCA Scholarship? _____ yes _____ no
If yes, what scholarship (convention, triennial, etc.) ____________________________ Year(s)?__________
Amount(s) $___________
FINANCIAL INFORMATION
Please calculate all income and expenditure figures yearly, not monthly.
2008 Anticipated Household Income $_____________________ Expenditures $______________________
Program costs (in detail) Please do not include these amounts in anticipated household expenditure amount above.
Tuition $__________________
Books $__________________
Supplies $__________________
Other $__________________
Total $ _________________
PLEASE READ CAREFULLY
Applicant must provide:
1. Completed Application Form
2. Letters of recommendation from two of the following:
· Pastor of applicant's congregation
· Women of the ELCA President of applicant's congregation
· Executive Board Member (President, Vice-President, Secretary, Treasurer) of applicant's congregation
3. Transcript from most recent education institution
4. Essay describing chosen career path, goals, how course(s) will help applicant reach stated goals (not to exceed 1,000 words)
PLEASE RETURN APPLICATION BY JULY 31, 2008 TO: L. Schweke, Treasurer
TX-LA Gulf Coast Women of the ELCA
8771 Pechacek Rd.
New Ulm, TX 78950