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STUDENT AID APP. MARILYN JACKSON APP. MINISTERS' DAY APP. SCHOOL FOR PASTORS APP.

A P P L I C A T I O N F O R M A R I L Y N A. J A C K S O N G R A N T

Application for Marilyn A. Jackson Grant

Applications will be accepted between January 1st and May 1st.

Part I
PERSONAL HISTORY

Name:

Street Address:

City:

State:

Zip:

Telephone Number:

E-mail Address:

Date of Birth:

Social Security#:

If you wish to be considered for this scholarship, please designate your racial/ethnic identity:

		:African American		:Alaska Native		:Asian American
		:Hispanic American		:Native American		:Other (specify)

Part II
EDUCATIONAL HISTORY (College & Seminary)

Institution	Date of Enrollment	Date Terminated	Degree	G.P.A.
Degree-granting college	mm/yyyy	mm/yyyy		College Graduate
Seminary attending	mm/yyyy	mm/yyyy
College (3)	mm/yyyy	mm/yyyy
College (4)	mm/yyyy	mm/yyyy
NOTE: Application is NOT complete without a transcript.

This coming fall, I will be a senior student at Seminary.

Part III
CHURCH HISTORY (College & Seminary)

Name of Church of which you are a Member:

Address of Church:

Under care of what Presbytery: