Applicant Name *

First Name

Last Name

Applicant Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Applicant Phone *

(###)

###

####

Applicant Gender *

Male

Female

Applicant Marital Status *

Single

Married

Widowed

Children? *

Yes

No

Commending Assembly Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Commending Assembly Phone

(###)

###

####

Current Assembly Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Current Assembly Contact Person *

First Name

Last Name

Current Assembly Contact Phone *

(###)

###

####

School/ Program Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date Program Begins *

MM

DD

YYYY

Academic Status *

Full-time student

Part-time student

Have you applied for admission? *

Yes

No

Have you been admitted? *

Yes

No

Date Needed *

When do you require the funds?

MM

DD

YYYY

Applicant Scholarship Agreement *

In submitting this application, I am acknowledging my intention to work full-time in an Assembly or Assembly-related ministry or on the mission field for at least two years following completion of my studies. If I am selected to receive a scholarship, I will be required to sign a formal statement of intent that includes an obligation to repay the scholarship grant in the event that I do not fulfill the two-year service requirement. I understand that there is no formal responsibility on my part to repay the Scholarship Fund. However, if I am involved in secular work, after I am self-supporting, I will seek to give an equivalent gift to the Scholarship Fund so that other deserving students may also be assisted financially.

I affirm Stewards Ministries' terms for this agreement.

I do not affirm (comment below).

Letters of Reference & Oversight *

Please have the elders of your Assembly forward a letter, to the address below, indicating their support of your educational plans. The letter should include: ✓ An acknowledgement by the elders that the scholarship funds will be distributed through the Assembly. ✓ A statement that the elders of that Assembly are willing to provide oversight for the recipient as needed. ✓ A statement that, in the event the recipient does not fulfill his or her declared intention, the elders will remind and encourage the recipient of his or her obligation to repay the scholarship grant. (The Assembly will not be responsible for the debt.)

Yes, I will ensure these forms are submitted to Stewards Ministries.

Applicant Electronic Signature *

First Name

Last Name

Today's Date

MM

DD

YYYY