You are on page 1of 2


First United Methodist Church
Chanute, Kansas

Date _______________ Application for:
_____ Fall Semester Year _____
_____ Spring Semester Year _____

Name Birth date _____________________

Address at Home Phone ________________________

Address at School Phone ________________________

High School Attended Date of Graduation _____________

High School Grade Point Average* __________________

College/University/Area Vocational Technical School most recently attended:


College/University/Area Vocational School Grade Point Average* _______________________

Name of College/University/Area Vocational Technical School you plan to attend:


Classification for next year/semester: (Circle) Freshman Sophomore Junior Senior

Numbers of accumulated college credit hours completed _______________________________

What are your plans for a certificate program or undergraduate degree? (Describe)

*For High School seniors, a seven semester, unofficial transcript must accompany this application.
*For College/University students, proof of academic standing reflecting all credit hours completed must accompany
this application.
What are your career goals? (List)

State your frequency of attendance in the following church programs during the last two years:

Church _____________________ Sunday School ______________________

Other church related youth activities: (please list) _____________________________________

List church activities and programs in which you have participated during the last two years.
(Examples: Vacation Bible School, Youth Group, musical groups, committees, UNDC Tour,
Mission Study Tour, Institute, etc.)

Signed _______________________________________

By signing this application, I acknowledge that I have read and understand the Estate Fund Scholarship

(Return completed application with unofficial transcripts to the First United Methodist Church Office no
later than June 1st for the fall and spring semester or January 31st for the spring semester)