COLEMON W. KERRY, JR. SCHOLARSHIP FUND
FRIENDSHIP MISSIONARY BAPTIST CHURCH
3400 BEATTIES FORD ROADCHARLOTTE, NC 28216
STUDENT INFORMATION
Last Name / First Name / MI / Age / Sex
Street Address / City / State / Zip Code
Phone Number
( ) / Your Email Address (Please Print) / Date of Birth (MM/DD/YYYY)
/ /
High School / Graduation Date
Have you been accepted into a college or university? /
YES NO / If yes, name of college or university attending:
Major (If applicable): / Grade Point Average:
(Non-Weighted)
Do you plan to live on campus? /
YES NO / Total estimated cost: / $
Are you approved for financial aid? /
YES NO / If yes, what is the source of the awarded aid and the amount? / Source:
Amount: $
Are you currently employed? /
YES NO / If yes, list the name of your employer:
Are you a member of Friendship Missionary Baptist Church? / How long have you been a member of Friendship Missionary Baptist Church?
Please list your FMBC membership number: / Please list your Mother’s Maiden Name:
Mother’s FMBC membership number (if applicable):
PARENT OR GUARDIAN INFORMATION - * LIST ONLY IF YOU LIVE WITH THIS PARENT
* Name of Father/Male Guardian / Occupation / Employer / How long at this employer?
* Name of Mother/Female Guardian / Occupation / Employer / How long at this employer?
Total Family Income (Annually) – Please place an “X’ in the box next to the range of your family’s income. /
Under $20,000 / $36,000 – $50,000 / $66,000 – $80,000 / Over $96,000
$21,000 – $35,000 / $51,000 – $65,000 / $81,000 - $95,000
Applicant’s Signature: ______Date: ______
Colemon W. Kerry, Jr. Scholarship Fund
Policies & Criteria
A. Types of Financial Assistance:
1. The Coleman W. Kerry, Jr. Scholarship Fund will award scholarships and/or grants to selected applicants who satisfy eligibility requirements. Scholarships will be awarded to students based on demonstrated need and evidence of outstanding academic performance. Grants will be given to students based on demonstrated financial need.
2. Loans are not available at the current time; however, the Board of Directors will periodically reassess the feasibility of making loans to students.
B. Eligibility Requirements:
1. To be eligible for financial assistance, an applicant must have been a member of Friendship Missionary Baptist Church for one calendar year prior to the deadline date for applications to be submitted. Also, the applicant must have a record of service and financial support to the church.
2. A recipient must be enrolled or planning to enroll as a fulltime student, as defined as a minimum of twelve (12) semester hours or nine (9) quarter hours. In addition, applicants must have a grade point average equal to or greater than 2.5 (non-weighted).
3. A recipient must be attending an accredited, postsecondary institution; this includes community colleges, technical institutions, trade/vocational/professional schools, and fouryear degree granting institutions.
4. Graduate students would not be eligible for financial assistance until such time as the Board of Directors sees fit to make financial aid available for graduate education.
5. Students awarded scholarships or grants are eligible for a one time renewal scholarship in subsequent years. To be considered for a one time renewal scholarship, a student must have a 2.5 grade point average or greater.
6. Eligible applicants applying for renewal must only submit an official transcript, containing official seal or signature, of their most recent grade report, (i.e. 1st semester grades), along with their completed application form by April 30th to be considered for financial assistance.
7. These materials must be submitted by April 30 to ensure consideration.
C. Number & Amount of Awards:
1. The number of scholarships and grants made each year will be based on the funds available, as determined by the Board of Directors.
2. The amount of financial assistance given to a recipient will be based on the funds available, his/her financial need, and the cost per term/year at the institution attended.
3. Eligible applicants are limited to two (2) scholarship awards; one as a first time applicant and one as a renewal applicant in a subsequent year, as funds are available.
D. Verification of Application Material:
1. The Board of Directors, through its official representatives, reserves the right to verify information submitted in support of an application for financial assistance and to request additional information when needed.
E. Selection of Aid Recipients:
1. The Board of Directors will make the final selections and approve all recipients of scholarships and grants.
2. All first time eligible applicants must submit to an interview by Board of Directors.
F. Administration of Scholarship and Grant Funds
1. Funds awarded to a student will be issued in the name of the institution the recipient indicates he/she will attend. If a recipient of financial assistance determines that he/she cannot enroll as intended, he/she must provide written notice to the Chairperson of the Board of Directors no later than ten (10) calendars before the semester begins.
ALL ITEMS ARE REQUIRED AND MUST BE SUBMITTED BY THE
APPLICATION DEADLINE OF APRIL 30TH.
ONLY COMPLETED APPLICATIONS WITH ALL NECESSARY ATTACHMENTS WILL BE CONSIDERED.
FAILURE TO MEET ALL REQUIREMENTS CAN RESULT IN DISQUALIFICATION.
Rev. 1/2016 K. Neal