NLCC Scholarship Form - New Life Community Church

Scholarship Application Form

    Applicant Information

    Date:

    Phone:

    Email:

    Number of Schools Applied to:

    GPA:

    Desired Scholarship:

    Position Applied for:

    Are you a member of New Life Community Church?

    YesNo

    Are your parent(s) members of New Life Community Church?

    YesNo

    If yes, how long have you been a member?

    Are you applying for more than one scholarship?

    YesNo

    Have you ever been suspended or expelled?

    YesNo

    If yes, explain:

    Education

    High School:

    Address:

    Graduation Date:

    Major:

    Extracurricular Activities:

    Awards/Recognition :

    References

    Please list three professional references of no relation.

    Full Name:

    Relationship:

    Company:

    Phone:

    Address:

    Full Name:

    Relationship:

    Company:

    Phone:

    Address:

    Full Name:

    Relationship:

    Company:

    Phone:

    Address:

    Previous Employment

    Company:

    Phone:

    Address:

    Supervisor:

    Job Title:

    Starting Salary: $

    Ending Salary : $

    Responsibilities:

    From:

    To:

    Reason for Leaving:

    May we contact your previous supervisor for a reference?

    YesNo

    Company:

    Phone:

    Address:

    Supervisor:

    Job Title:

    Starting Salary: $

    Ending Salary : $

    Responsibilities:

    From:

    To:

    Reason for Leaving:

    May we contact your previous supervisor for a reference?

    YesNo

    Signature

    I certify that my answers are true and complete to the best of my knowledge.
    If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

    Signature:

    Date:

    Submit