Seminary Scholarship Application

For Academic Year: 20 - 20

College

or Extension Center:

Social Security # - -

Submit your Application online, or print it
and mail it to the address below:

MISSISSIPPI BAPTIST FOUNDATION
P.O. Box 530

Jackson, MS 39205-0530

Phone: 1-800-748-1651, 601-292-3210

BIOGRAPHICAL INFORMATION:

Name:	Date of birth:
E-Mail:	Phone:

Address while in school:

Permanent address:

Home Church: Home town:

Marital Status: Spouse's Name:

Number of dependents: Relationship:

Are you licensed? yes no Ordained? yes no

Are you a member or previously a member of a Mississippi Southern Baptist Church? yes no

If so, how long have/were you a member? Name of church:

Name of church where you are currently a member:

Pastor’s name:

Pastor's Address:

(Note: If you are currently serving as a pastor, use the AMD for your association)

List all educational institutions attended since high school (include your current school):

Institution:	Location:	Years Attended:	Degree Received:	G.P.A.:

Current college degree program:

Start date: Expected graduation date:

Hours complete in current program: GPA

Seminary Hours currently enrolled:

Campus groups or activities in which you are active :

Would you be willing to share a brief testimony expressing the encouragement a Mississippi Baptist Foundation scholarship has had on your life and ministry? yes no

If so, please list below the names and addresses of two (2) friends or relatives who normally would know your address after graduation:

(1) Name: Address:

(2) Name: Address:

Specific ministry for which you are preparing and why:

Pastoral	Music	Education	Foreign Missions	Other
Youth	Children	Counseling	Home Missions

Why?:

Previous awards from the MBF Scholarship Ministry:

DATE:	SCHOLARSHIP:	AMOUNT:

Gifts, scholarships and grants received or pledged from all sources for upcoming college semester:

Please Transfer from worksheet: [+]Personal Worksheet

Total income: Total Expenses:

Note any special reasons for your request for financial assistance:

List below the names and addresses of two persons as references such as employer, counselor, teacher,church staff person, etc. (please do not list relatives).

(1) Name: Address :

(2) Name: Address:

*Application will not be complete until we have received BY MAIL: a signed Release of Information form (which can be printed from this site), Letter of Recommendation, and a brief testimony of your life.

I attest that the information given is true and accurate to the best of my knowledge and hereby authorize release of academic or financial information necessary for the review of this application.

Applicant’s Online Signature: Social Security Number:

AUTHORIZATION FOR RELEASE OF CONFIDENTIAL STUDENT INFORMATION:

I, , whose Social Security number is ,

do hereby authorize the release of academic or financial information from .

To the Mississippi Baptist Foundation

PO Box 530, Jackson MS 39205

Signed:    Date:     Phone number: