(Print out and fax or mail to the Regional Office with the application package.)

Eastern Regional Association
Advent Christian General Conference
SCHOLARSHIP FINANCIAL NEED FORM

All information given on this statement will be kept confidential by the Board of Directors of the Eastern Regional Association of the Advent Christian General Conference.

NAME  
DATE  
EMAIL  
NAME AND ADDRESS OF SCHOOL
                                                                                                                                                                   

                                                                                                                                                                    

ESTIMATED ANNUAL EXPENSES FOR THE YEAR TO WHICH AID APPLIES:

Tuition and fees $____________________________
Books and supplies $____________________________
Rent or room, including utilities $____________________________
Food or board and household supplies $____________________________
Clothing, laundry and cleaning $____________________________
Medical and dental $____________________________
Transportation $____________________________
Payment on past indebtedness $____________________________
Other expenses $____________________________

Total Expenses

 $____________________________

ESTIMATED ANNUAL RESOURCES FOR THE YEAR TO WHICH AID APPLIES

Resources from parent or guardian $____________________________
Resources from spouse, if married $____________________________
Savings from summer earnings $____________________________
Earnings during the school year $____________________________
Grants or scholarships already received $____________________________
Veterans GI Benefits $____________________________
Social Security Benefits $____________________________
Educational loans already received $____________________________
From other sources $____________________________

Total Resources

 $____________________________

Personal statement of need: (Use back of sheet if necessary.)

 

Signed ____________________________________________

*Please return this form with your application.

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