How should we contact you?

• If you have previously received financial aid, it is not necessary to fill-out the pastoral reference section of this application.
• Scholarships do not cover the cost of textbooks

I am applying for the "Mission to the City" Scholarship and plan to earn the following degree:

I do hereby pledge to diligently attend scheduled classes, to perform to the best of my ability, and to heed the counsel of my pastor.  I understand that I do not have to succeed in order to qualify for financial aid; however, I must diligently try to succeed, as evidenced by my faithful attendance at class. I further agree that, should I at any time begin to question the stated teachings of the Christian Faith, in general, or my home church, in particular, I will immediately bring such questions to the attention of my professor and my pastor, to the end that I may benefit from the counsel of those committed to my oversight.

Should I miss two or more classes in a course, without excuse, I agree to reimburse one-half of the scholarship amount I received for the course so that these funds may benefit others. I also understand that if I switch from credit to audit status my scholarships will be forfeited.

Signed *

Date *

Witnessed

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