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