Applicant Name

Applicant Birthdate (if under 21)

Address

Email

Phone

What Church/Community activities do you participate in?

Affiliation with CRUMC (please click one of the below) Affiliation with CRUMC (please click one of the below) Member Regular Attendee Other

What has CRUMC meant to you/how has it played a role in your spiritual development?

Please list other activities in which you participate (employment/volunteer work/sports)

High School Graduation/GED Date

Name of current/future school/college

Location of current/future school/college

When are your school funds due?

What is your course of study and over what time frame?

List other scholarships/grants for which you have applied/received

Note any extenuating financial needs to be taken into consideration

Proposed course(s) (click all that apply) Proposed course(s) (click all that apply) Certification Courses Trade/Vocational Courses Undergraduate Course Graduate Course

Additional description or comments

Give the best estimate for total costs including tuition and book expenses for the upcoming semester/term/course.

I (Applicant) understand that the Foundation will award grants based on the number of requests and available funds. I (Applicant) understand that the Foundation will award grants based on the number of requests and available funds. Yes No

By clicking yes, Applicant agrees this serves as electronic signature. By clicking yes, Applicant agrees this serves as electronic signature. Yes No