ARKANSAS DISTRICT YOUTH

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1 ARKANSAS DISTRICT YOUTH Dear Applicant: Greetings from the Youth Department! We appreciate the interest you have shown in the Ladies Ministry Scholarship Program and are happy to send you the needed information and various application forms. The Youth Department is pleased to provide the Arkansas Youth Scholarships in the amount of $500.00, annually, to a male and female recipient, to the UPCI Bible College of their choice. The entire scholarship is made available to the recipient during the first year of enrollment, with the funds being disbursed at the beginning of each term or semester. Please note also the scholarship applicants are not restricted to high school graduating seniors; however they must be under 25 years of age. Further, to have attended a UPCI Bible College or any other secular college previously would disqualify an applicant from consideration. Attached to this letter, you will find the application form and three reference forms, including; Pastoral Reference, Scholastic Reference and Employment Reference. IT IS YOUR RESPONSIBILITY TO SEE THAT YOUR COMPLETE APPLICATION AND THE REFERENSES FROM YOUR PASTOR, SCHOOL, AND EMPLOYER ARE ON FILE IN OUR OFFICE NOT LATER THAN MAY 1. The reference forms must be mailed by the pastor, school representative and employer. It is suggested that you provide them with a stamped envelope addressed to the Youth Department. ALSO, BE SURE TO REMIND YOUR SCHOOL THAT A TRANSCRIPT OF YOUR HIGH SCHOOL GRADES MUST ACCOMPANY THE SCHOLASTIC REFERENCE. This is EXTREMELY IMPORTANT!!! Remember, in order for your application to be valid, every question or blank must be answered completely, and a RECENT PHOTO MUST BE ATTACHED. If you have any questions, please feel free to call or write us at the Youth Department. May God's best be yours! Sincerely, Arkansas Youth

2 ARKANSAS YOUTH SCHOLARSHIP APPLICATION Arkansas Youth, Arkansas District United Pentecostal Church International Arkansas Youth Department Chantry Dean 202 Callie Lane Centerton, AR DIRECTIONS: Application must be legible and the essay typed with double spaces. It is your responsibility to mail your application so that your completed application is received by the Arkansas Youth Department by MAY 1st. Your application will NOT be complete until all three references forms and transcripts are on file in our office. Return the application to the above address. PERSONAL HISTORY Date Name Age Address Date of Birth City State Zip Phone( ) - Sex -(circle one)- M F Marital Status ( circle one): Single Married Widowed Divorced Health Status (circle one): Above Average Average Below Average Do you know of any health factors (physical or emotional) of which we should be aware? If so, please explain: Attach recent photo here. Application will not be considered without photo

3 Father's name Occupation Mother's Name Occupation Guardian s Name Occupation SCHOLASTIC HISTORY School Attended Name Address Major GPA Dates Attended Degree *If you need more space, continue on a separate piece of paper and attach. List any other scholastic information to your application (ie, honors, awards, clubs, etc.) Company Name EMPLOYEMENT HISTORY List from most recent (list only three): Address Date Employed Full Time or Part Time Job Title/Description

4 FAMILY INCOME HISTORY (Round all figure to nearest dollar) Parent s net income for last year $ Number of dependants Applicant s net income for last tax year Describe what your plans are for financing your college education: CHRISTIAN SERVICE Have you been baptized in Jesus name? Date Place Have you received the Baptism of the Holy Ghost according to Acts 2:4? Date Place Name and address of the church you attend: Pastor's Name and Address Pastor's number Are you living a consistent Christian life to the best of your ability? List and describe any church related activities in which you have been or are now involved (youth ministry, bible quizzing, Sunday school, choir, orchestra, evangelism, etc.) Do you feel a call to any particular area of Christian or public service? explain: ESSAY On a separate piece of paper, express in your own words, why you would like to attend college. Explain what contribution you believe education can make to your life and how you plan to utilize these benefits in your future. The essay should be words, typed and double spaced. Applicant's Signature Date Pastor's Signature Date

5 IMPORTANT!!! It is your responsibility to see that your completed application is received by Arkansas Youth by May 1. Your application will NOT be complete until all three forms and transcripts are on file in our office. RETURN APPLICATION TO: Arkansas Youth Chantry Dean 202 Callie Lane Centerton, AR COLLEGE CHOICE Indicate below which endorsed Bible college you are interested in attending. Check one only-- (checking more than one will disqualify you from consideration) Apostolic Bible Institute-ABI St. Paul Minnesota Christian Life College, Stockton California Indiana Bible college-ibc Indianapolis, Indiana Texas bible College, Lufkin,Texas Apostolic Missionary Institute Oshawa, Ontario, Canada Gateway College of Evangelism, St. Louis Missouri Northeast Christian College, Fredericton, New Brunswick, Canada Urshan Graduate School, St. Louis Missouri

6 ARKANSAS YOUTH SCHOLARSHIP SCHOLASTIC REFERENCE (confidential) Student School State To school Principal or Official: The student who has given you this reference form is applying for a scholarship provided by the Youth Department of the Arkansas District UPCI. Your prompt reply is deeply appreciated and will be held in the strictest confidence. Please enclose a transcript of the applicant's grades with this form before May 1 and mail to: Arkansas Youth UPCI Chantry Dean 202 Callie Lane Centerton, AR Please evaluate the student in the following areas: Top 10% Emotional Stability Personal Appearance Moral Character Personal Initiative Cooperativeness Respect for Authority Leadership Ability Personal Development Consideration for Others Consistency Personal Responsibility Academic Achievement Classroom Participation Above Average Average Below Average Inadequate Do you know of any health factors (physical or emotional) of which we should be aware? If so, explain: How long have you known the applicant? Would you recommend this individual, without exception, for a scholarship?

7 ADDITIONAL COMMENTS: Signature Date Title or Position

8 ARKANSAS YOUTH SCHOLARSHIP EMPLOYMENT REFERENCE (confidential) Student School State To Employer: The student who has given you this reference form is applying for a scholarship provided by the Youth Department of the Arkansas District UPCI. Your prompt reply is deeply appreciated and will be held in the strictest confidence. Please enclose a transcript of the applicant's grades with this form before May 1 and mail to: Arkansas Youth UPCI Chantry Dean 202 Callie Lane Centerton, AR Please evaluate the student in the following areas: Top 10% Emotional Stability Personal Appearance Moral Character Personal Initiative Cooperativeness Respect for Authority Leadership Ability Personal Development Consideration for Others Consistency Personal Responsibility Academic Achievement Classroom Participation Above Average Average Below Average Inadequate Do you know of any health factors (physical or emotional) of which we should be aware? If so, explain: How long have you known the applicant? Would you recommend this individual, without exception, for a scholarship?

9 ADDITIONAL COMMENTS: Signature Date Title or Position

10 ARKANSAS YOUTH SCHOLARSHIP PASTORAL REFERENCE (confidential) Student School State To Pastor: The student who has given you this reference form is applying for a scholarship provided by the Youth Department of the Arkansas District UPCI. Your prompt reply is deeply appreciated and will be held in the strictest confidence. Please enclose a transcript of the applicant's grades with this form before May 1 and mail to: Arkansas Youth UPCI Chantry Dean 202 Callie Lane Centerton, AR Please evaluate the student in the following areas: Top 10% Emotional Stability Personal Appearance Moral Character Personal Initiative Cooperativeness Respect for Authority Leadership Ability Personal Development Consideration for Others Consistency Personal Responsibility Academic Achievement Classroom Participation Above Average Average Below Average Inadequate Do you know of any health factors (physical or emotional) of which we should be aware? If so, explain: How long have you known the applicant? Would you recommend this individual, without exception, for a scholarship?

11 To Pastor (cont) How long have you known the applicant? Is the applicant actively involved in the activities of the church? Please elaborate: Please describe any other church related activities in which the applicant has been or is now involved (Sunday school, choir, orchestra, evangelism, etc.) The financial need of an applicant is not a major factor in awarding the LM scholarship, however it is taken into consideration. With this in mind, how would you evaluate the financial status of the applicant and the applicant's family? Average Above Average Below Average Will the applicant's family be able to assist with any expenses incurred in attending college? To your knowledge, is the applicant planning to seek employment to help finance his/her college? Do you know of any health factors (physical or emotional) of which we should be aware? If so, explain: Would you recommend this individual, without exception, for a scholarship? If not explain: Pastor Signature Date

12 ADDITIONAL COMMENTS: Signature Date Title or Position

13 CHECK LIST Completed Application Photo Typed Essay Applicant's Signature Pastor's Signature Pastor has received a copy of the Scholastic Reference Form with addressed envelope All schools have received a copy of the Scholastic Reference Form with addressed envelope Employer Reference Form has been given to the most recent Employer with addressed envelope

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