The Impact Scholarships are thirteen individual scholarship opportunities designed to assist students with very specific backgrounds or areas of ministry. These scholarships are merit based and applications are considered on a competitive basis.

Please check, or highlight, all the following Impact Scholarship you would like to apply for:

☐Archeology

☐Biblical Counseling

☐Chaplaincy

☐College at Southwestern

☐Ministry Team (Husband and Wife Students)

☐Christian Education Studies

☐Campus Employees Scholarship

☐Ethics Studies

☐Women's Student Scholarship

☐Disabled Student Scholarship

☐International Student Scholarship

☐Minority Student Scholarship

☐Preaching and Pastoral Studies

☐By State

The Impact Scholarships are merit based scholarships provided to currently enrolled students primarily on the basis of the competitiveness of their application. It is not possible for Southwestern to provide for the total budget needs of students. Any assistance which can be provided by the Office of Financial Aid is supplemental to other income which a student may receive from employment, church and/or denominational support. Therefore, students are expected to relinquish the Scholarship when their tuition is provided by other sources.

Please complete all information in the space provided.

I. Personal Information

Student ID: ______Email:

First Name: ______Last Name: ______

Address: ______

City: ______State: ______Zip: ______

Home Phone: (___) ___ - ____Phone:(___) ___ - ____

II. Family Information

Current Marital Status (circle or highlight one) Single Married Divorced Separated Widowed

Have you ever been divorced? ☐ Yes ☐ No

Spouse Name:______

Please list names and ages of children______

III. Citizenship Information

Place of Birth City: ______State:______

Date of Birth:______Country of Origin: ______

Citizenship: ______Visa: ______

Ethnicity[1]: ______

Home City: ______Home State: ______

Number of years in home city:______If Texas, what county: ______

Secondary home town/state: ______

IV. Church Information

Name of church endorsing you to seminary:______

Address of that church:______

City:______State:______Zip:______

V. Military Information

Have you ever served in the military? ☐ Yes ☐ No

If yes what branch?______

VI. Education Information

Previous school(s) attended (please list school name, dates attended and degree earned):

______

VII. Parental Information

Is your parent(s) a missionary? ☐ Yes ☐ No

Is your parent on church staff? ☐ Yes ☐ No

If yes what position?______

VIII. Degree Being Pursued

Campus Attending: ______Degree Currently Seeking: ______

Area of Concentration: ______Hours Completed: ______

Hours Currently Enrolled: ______Semester 1st Enrolled In Degree: ______

Expected Graduation Date: ______Cumulative GPA: ______

Expected Enrollment Fall: ______Expected Enrollment Spring: ______

If Less Than 10 Hours Please Explain: ______

If GPA below 2.5 what problems were encountered: ______

Further Degree Desired at SWBTS: Yes/No What Degree: ______

IX. Church Related Ministry Information

Name of Church Where Currently A Member: ______

Is the Church Part of the SBC? ☐ Yes ☐ No Present Staff Position: ______

How long in present position? ______

Present unpaid leadership role in your church______

Previous ministerial experience______

What are your future plans for ministry after graduation from seminary?

______

Share your personal testimony and call to ministry.

______

Provide significant contacts that may help you in ministry or area of large impact.

Give names and addresses of three references, (if you are a current student please provide one professor or administrative staff person atSouthwestern).

______

X. Family Monthly Income Information

Name of Employer: ______Monthly net income: ______

Name of 2nd Employer______Monthly net income: ______

Name of Spouse's Employer: ______Monthly net income: ______

Name of Spouse's 2nd Employer: ______Monthly net income: ______

Monthly gift from church: ______Monthly gift from family: ______

Monthly gift from foundation: ______Other monthly income: ______

Total Monthly Income: ______

XI. Family Monthly Expense Information

Tithe: ______Savings (monthly contribution): ______

Rent: ______Mortgage: ______Does rent include utilities? ☐ Yes ☐ No

Health Insurance:______Dental Insurance: ______

If you do not have health insurance please indicate here: ______

Auto Insurance:______Renters Insurance: ______

Groceries: ______Phone: ______

Cell Phone: ______Utilities: ______

Laundry: ______Clothing: ______

Transportation: ______Car Note: ______

Credit Card Payments: ______Educational Loans: ______

OPC Payment: ______Child Care: ______

Recreation: ______Prescriptions: ______

Incidentals: ______Other: ______

Total Monthly Expenses: ______

Tuition and Fees per semester: ______Books per semester: ______

School Supplies: ______

Outstanding Debt (Total Amount due to creditor – not monthly payment)

Home Mortgage: ______Rental Land/Property: ______

Educational Loan: ______Credit Cards: ______

Car Note: ______Medical Bills: ______

Other Debt: ______Other Debt: ______

XII. Personal Statement

Please state briefly why you feel you should be considered for a scholarship, add any additional information you would like to provide, as well as your ministry plans.

XIII. Final Authorization

I affirm the correctness of the submitted answers and, in the event a grant is made to me, I promise to use itfor no other purpose that the necessary expenses of continuing my theological education. I certify that I haveread and understand the terms and conditions of this grant, and I approve and accept the requirementscontained in them:

If a grant is made to me, I further promise:

  1. To write a thank you letter to the scholarship donor if requested by the Office of Financial Aid;
  2. To answer promptly all letters relating thereto, including correspondence with donors, if required;
  3. To keep the Office of Financial Aid informed of my address and advised of the character of my work andmy changes in remuneration affecting financial needs, as long as such information is needed;
  4. In accepting this scholarship I agree to abide by all moral commitments of SWBTS and to be in chapel every day unless providentially hindered or have an agreement with the dean of Students based on unusual circumstances.
  5. To attend the annual donor appreciation banquet if required;
  6. To maintain records regarding awards received and actual payment of tuition and course relatedexpenses in compliance with the current tax laws and IRS regulations. You may wish to contact theIRS or a tax advisor regarding the tax implications of your awards.

In making this application for aid, I agree if aid is granted to devote mybest efforts to the educational opportunity afforded by this aid.

Signature: ______Date: ______

[1]Some donors established scholarships to be exclusive to certain ethnicities. To be considered for one of these scholarships, youmay opt to provide this information. SWBTS does not discriminate on the basis of ethnicity in the award of scholarship funds.