THE FLORIDA UNITED METHODIST FOUNDATION, INC. Hilburn-Prine Student Loan Application P. O. Box 3549 Lakeland, FL

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1 General Information: THE FLORIDA UNITED METHODIST FOUNDATION, INC. Hilburn-Prine Student Loan Application P. O. Box 3549 Lakeland, FL Name of Student: Home Address: School Address: Home Phone: ( ) - Cell Phone: ( ) - School Phone: ( ) -, extension Birthdate: / / Social Security Number: - - Projected Graduation Date: / / Name and address of the church where student is a member: Pastor s Name Pastor s Phone Number ( ) - ; Pastor s address Marital Status: ( ) married; ( ) single; ( ) separated; ( ) divorced Are You a U. S. Citizen? Are You a legal Florida resident? Academic Plans: Please identify the college or university you will be attending Where is the college/university located? (city and state) HP Application 1

2 Are you currently enrolled in a college or university? If yes, what is the name of the school? What grade level will you be for the term you are applying? What is the intended workload for the term you are applying? If Not enrolled full time, explain reason Indicate expected degree For what career are you preparing? G. P. A. Have you ever been on academic probation? Please explain If you are clergy, indicate your conference status Employment: Are you currently employed? Where? Will it be necessary for you to work during the coming term? Church Involvement: What date did you become a full member of The United Methodist Church? Please describe your church-related activities. Have you had a leadership role? Have you been HP Application 2

3 active in specific ministries or missions? Family Information: Father s Name: Address: Father s Home Phone: ; Father s Cell: Father s address: Mother s Name: Mother s Home Address if different from applicant Mother s Home Phone: ; Mother s Cell: Mother s Address: Father s Occupation/Employer: Mother s Occupation/Employer: Number of Siblings: Are any siblings currently attending a college, university or graduate school? Approximate combined income of parents: Spouse s Name HP Application 3

4 Spouse s Occupation Combined Income (you & spouse) Number of persons dependent on your income and that of spouse: Financial Information: A. Amount of loan requested: $ * *The amount of the loan granted will be determined by cash available and the number of student applications. B. On a separate sheet please list: 1. All costs for the semester; 2. Sources and amounts of all funds to be used in meeting costs. (Please see Financial Worksheet that is provided with this form.) C. Do you currently have other student loans? Yes No D. If yes, list on a separate sheet the loans incurred, indicating the amount borrowed and the repayment terms for each loan. E. On a separate sheet, briefly explain why you need this loan. In conjunction with this loan application, I hereby authorize The Florida United Methodist Foundation, Inc. to obtain a copy of my credit report from a credit bureau. Information from this report will be considered in the approval/denial of loan requests. Date: / / Signed: Print Name: References: Please submit three (3) letters of recommendation from your pastor, family and/or friends. You may use a relative other than a parent. If you are related to your senior pastor, please ask another member of the pastoral or church administrative staff to verify your church membership. You may use family friends who are familiar with your character, your academic abilities and/or your church and community activities. Your application packet must include the following: 1. A complete loan application, signed and dated 2. A financial worksheet 3. One-page essay on why you need loan; include future plans. HP Application 4

5 4. Three letters of reference 5. A signature sheet signed by you and your prospective co-signer Please submit to: Florida United Methodist Foundation P. O. Box 3549 Lakeland, FL Street Address: 450 Martin Luther King Jr. Avenue Lakeland, FL (866) toll free (863) local number (863) fax Web site: HP Application 5

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