Herbert Rohloff Sr. Scholarship Application Adelphi Sunday School Class First Methodist Houston -ยงApplications for the fall semester must be received by July 2, 2014. The scholarship grant is per semester/quarter. Late applications, letters of recommendation, and transcripts received after the deadline will be not be considered.
Please provide the following information: 1) Full Name _______________________________________________________ 2) DOB: ______________ 3) Current Home Address __________________________________________________________________ ________________________________________________________________________________________ 4) Phone # ________________Cell # __________________ E-mail address__________________________ 5) Name and address of College/school you will attend: _____________________________________________________________________________________ _______________________________________________________________ Class hours____________ 6) Name and address of College Financial Aid Office for scholarship funds: ______________________________________________________________________________________ ______________________________________________________________________________________ 7) Citizen of US? 8) Marital Status:
Yes
No Single
If no, supply valid visa # __________________________________________ Married
9) Are you or any of your relatives a member of First Methodist Houston? Yes No If yes: Name/relationship ______________________________________________________________ Name/relationship _____________________________________________________________ 10) Your present church affiliation_____________________________________________________________ 11) Church activities in which you now or will participate? ________________________________________________________________________________________ __ _____________________________________________________________________________________ 12) Education: Name of High School ___________________________________________Year graduated ________ Name of College/s ____________________________________________ Years attended ________ Name of College/s _____________________________________________Years attended ________ 13) SAT/ACT score ____________________ Year taken ___________________
14) Describe briefly college/school activities in which you now or will participate: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ 15) Expenses - List expected expenses for the next semester/quarter - school related: Tuition/hours Housing (rent) Transportation
$ _____________ $ _____________ $ _____________ Total of above
Books/supplies $ ______________ Meals $ ______________ Other (define) $ ______________ $ _____________
16) Income - List expected income from any sources for the next semester/quarter: Family $ ____________________ Gifts/Scholarships $ ____________________ Loans $ ____________________ Total of above $_____________________ 17) Provide a brief summary of your choice of study and why this scholarship is of importance to you. ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ 18) Send by U.S. Mail to Adelphi Scholarship, First Methodist Houston,1320 Main St., Houston, TX 77002, with the following items on or before July 2, 2014 for an application to be considered: • Two (2) recent letters of recommendation that include the name and title of the letter writer. • Certified copy of recent college transcript of grades and courses. Submitting this application indicates the sender has provided his or her information as true and complete. If requested by the Adelphi Scholarship committee for additional information, the submitting person shall provide the proper data. All funds awarded will be paid directly to the college/school for the recipient’s behalf. If for any reason he/she does not enroll and attend classes, the received funds paid for the recipient, must be returned to the Scholarship fund. Accept
:
Do NOT accept
This application will be copied and sent to members of the Scholarship Committee – Adelphi Sunday School Class - First Methodist Houston.
Rev 5/12/14