2017 – 2018 Academic Year Scholarship Application

Church in New York City

87-60 Chevy Chase Street

Jamaica Estates, NY 11432

Tel: (718) 454-1826

Fax: (718) 454-4834

Instructions:

  1. The scholarship available is based on academic excellence. Applicants must fill in pages 2 and 3 of this application form and sign the application at the bottom of page 3. You must provide all information listed in the application form. Any omission may result in your disqualification. The Selection Committee considers the essay as an important component in the decision making process for awarding each scholarship.
  2. Applicants must be in a matriculated program in an accredited college. This year, the minimum GPA for consideration for a scholarship is 3.0 (or being the top 25th percentile of your class). For freshmen applicants, the minimum for consideration will be a B-average in high school. First semester college grades, if available for freshmen, are a plus. For those who are unable to meet these minimum requirements, you may still apply and make your case for consideration. The Selection Committee will review each case on its individual merits.
  3. All members of the Church in New York City who have attended church meetings for at least 1 year and who are undergraduate students or graduate students in any accredited college are eligible to apply for this scholarship.
  4. All freshman applicants must attach a photocopy of their SAT score or its equivalent and a photocopy of their high school transcript.
  5. All college student applicants, sophomore and above or graduate students, must attach a copy of their latest cumulative transcript. Transfer students should supply transcripts for each academic institution attended, starting with the most recent institution. Since this is an academic scholarship, transcripts are mandatory. If for some reason you do not complete courses for the period(s) indicated on your application, please notify the Scholarship Committee.
  6. The completed applicationmust be sent back to the Scholarship Committee. You may send itbyemail to , or we will also accept hard copies. If you are sending hard copies please send your hard copies by regular mail toc/o the Church in New York City at the address listed above.
  7. The deadline for receipt of completed applications is December 10, 2017.
  8. The submission of your application does not mean that you will be automatically awarded a scholarship. Each application will be given careful consideration.
  9. All awarded scholarships are for the 2017 – 2018 academic year. Applicants must reapply each year for consideration for that year’s awards.
  10. If your permanent address is overseas, please use your local address on the application form.

PERSONAL INFORMATION:

Name: (Last, First, MI) ______Date: ______

Permanent Home Address: ______

City: ______State: ______Zip: ______

Father's Name: ______Mother's Name: ______

Phone #1: ______Phone #2 ______

Resident Status (Circle One): U.S. Citizen Permanent Resident OtherGender (Circle One): M / F

Date of Birth: ______Date of Baptism: ______Current Standing (Circle One): Freshman Sophomore Junior Senior GraduateSchool

Other (Specify):______

Current / IntendedCollege and Major or Course of Study: ______

______

Please provide a full educational background from high school through graduate school or business / technical school. Include school or college name, date of graduation and grade point average.

Current Name of Institution, City, State: ______

______

Your plans for the next academic year: (Check all that apply.)

Fall Semester/QuarterWinter QuarterSpring Semester/QuarterSummer Term

Full Time: ______Part Time: ______Expected Date of Graduation: ______Dates started: ______GPA:______

Past Institution Name, City, State: ______

______

Date of Graduation: ______Dates attended: ______Degree:______GPA:______

Past Institution Name, City, State: ______

______

Date of Graduation: ______Dates attended: ______Degree:______GPA:______

Past Institution Name, City, State: ______

Date of Graduation: ______Dates attended: ______Degree:______GPA:______

Freshmen only:

SAT Scores (or Equivalent -- Specify) Total: ______Critical reading: ______Math: ______

Written: ______Date taken ______(attach copy)

______

Merit Scholarships and Financial Aid Received for Academic Year 2017-2018:

Source: Amount: ______

Source: Amount: ______

Source: Amount: ______

Source: Amount: ______

Source: Amount: ______

(Attach additional sheet if necessary)

Essay instructions:

It is important for the evaluation process that you write an essay on one of the topics listed below. This personal statement helps us to become acquainted with you as an individual in ways different from courses, grades, test scores and other objective data. It should be approximately 500 words long and on a separate piece of paper. If youapplied for this scholarship in a previous academic year, you mustchoose a different essay topic each year. You are not required to write about any spiritual subject nor make references to your spiritual experiences unless it is relevant. Please indicate which essay topic you chose for your essay.

1.Evaluate a significant achievement that has special meaning to you. Explain how it changed your way of living, behavior, attitude, perceptions and/or values. Please note: Studying abroad for a period of one or more semesters alone is not considered a significant achievement unless you can show tangible results accomplished during your time there.

2.Discuss some issue of personal, local, national or international concern and its importance to you.

3.Indicate a person who has had a significant influence on you and describe that influence.

4.Describe how your undergraduate or graduate studies might enable you to contribute to improving our quality of life in the twenty-first century.

Signature: ______Date: ______

For informational purposes only please tell us:

  1. Number of church or home meetings you attend each week ______
  2. Number of times you participate in the church service each month ______
  3. Number of minutes you spend each day reading the Bible and/or spiritual books ______

Page 1 of 3