Applicant Interview Process & Form – Fletcher’s Chapel United Methodist Church

As part of the application process, you may be asked to attend a personal interview with the church scholarship committee. If you are out town and will not be available for an in-person interview during this time frame, you must request a virtual interview which is available for certain circumstances and on a limited basis. Please do not submit an application if you are unable to interview as you will not be eligible to receive a Willard Scholarship.

PLEASE NOTE: Application MUST be filled out by student applying NOT parent. Applicant Information MUST be Student name and email NOT parent. For High School Students: Please complete the form as completely as possible. If a certain field on the form is not applicable to you then please use “not applicable” as a response

Student Contact Information

Name(Required)

First Last

Phone (Home)(Required)

Phone (Cell)(Required)

Email Address(Required)

Email Address

Parent/Guardian Name(Required)

First Last

Parent/Guardian Phone(Required)

Parent/Guardian Email(Required)

Permanent Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

PLEASE NOTE: All correspondence “Including checks” will be sent to the mailing address indicated above.

Additional Student Information

Date of Birth(Required)

Gender(Required)

Male

Female

Last four digits of Social Security Number(Required)

Country of Birth(Required)

Citizenship Status(Required)

U.S. Citizen

Permanent Legal Resident

Marital Status

Single

Married

Within your family, are you first generation to attend college?

Yes

Do you have any relatives who are current members of Fetcher's Chapel United Methodist Churchrs?(Required)

Yes

If yes, please provide name:

First Last

How did you hear about the Willard Scholarship?(Required)

Have you previously received the Willard Scholarship?(Required)

Yes

If yes, what year(s) did you receive the Willard Scholarship

Have you applied for the Willard scholarship in the past?(Required)

Yes

If yes, when did you apply?

Educational Background

High School Information

Name of High School(Required)

GPA(Required)

If high school did not use 4.0 scale, please convert to 4.0 scale

City(Required)

State(Required)

Dates Attended(Required)

Graduation Date(Required)

College/University Information

Name of Most Recent College or University Attended

GPA

Dates Attended

Type of Degree Earned

Name of Previous College or University

GPA

Dates Attended

Type of Degree Earned

Proposed College Information

College/University you plan to attend in Fall or to which you have applied (list in order of preference)

Name of School(Required)

Have you been accepted?(Required)

Yes

Name of School

Have you been accepted?

Yes

Name of School

Have you been accepted?

Yes

Category of school you plan to attend in Fall(Required)

If you are planning to attend an out-of-state or private school, please explain why:(Required)

Degree you will be pursuing in Fall(Required)

College/University Year in Fall(Required)

Expected course of study or college major(Required)

Occupation or profession for which you are preparing(Required)

Expected number of credits you will be taking each semester/quarter(Required)

Expected year of graduation – Year only(Required)

Honors/Activities/Employment

Resume Mandatory

NOTE: You may either (1) scan and upload your completed Resume or, (2) mail your completed Resume to Fletcher’s Chapel, PO Box 206, Hoffman, NC 28347. Resume must be received by September 15th. IMPORTANT – Do Not Print or Write your resume – just like a professional resume IT MUST be typed. NOTE the upload will only accept documents in a pdf format – you can choose to mail your documents to the office.

File

Max. file size: 256 MB.

Income – Student and Student's Spouse

Student's Employer

Student's Occupation

Student's Total Yearly Income

Student's Total Expected Earnings in current year

If student projects a loss of income, please explain why: Spouse's Employer

Spouse's Occupation

Spouse's Total Yearly Income

Spouse's Total Expected Earnings in current year

If spouse projects a loss of income, please explain why:

Student Debt

If any of the following items do not apply to you, simply enter “0”. When answering the following questions, only include student loans that are in your (the applicant) name. Do NOT include Parent PLUS loans that have been taken out in your parents’ name on your behalf.

Federal student loans – current balance(Required)

Private student loans – current balance(Required)

Parent/Guardian Information

Father/Legal Guardian Name(Required)

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Marital Status

Single

Married

Employer

Occupation

Mother/Legal Guardian Name(Required)

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Marital Status

Single

Married

Employer

Occupation

Parent Income

Personal Statement

The Personal Statement consists of: 1. One question (up to 250 words) 2. An informal Bio – see format explanation (up to 350 words) and 3. A Personal Essay (up to 500 words).

NOTE: You can: (1) type your personal statement directly into the box below; or (2) cut and paste your personal statement from Microsoft Word into the box below. Please use spell-check for your personal statement!

This is the only method to submit your personal statement. We will not accept personal statements via U.S. Mail, fax or email.

Please note that a personal essay written by anyone other than the applicant will not be considered. Parents may submit a separate statement (via US Mail or email to [Email Address]) addressing financial or other confidential matters, but the student (applicant) must write the following personal statement him/herself for the application to be evaluated.

Describe a disappointment/challenge you had and what it taught you about yourself.(Required)

Up to 250 words

Create a short informal Bio that highlights; who you are, what you would like us to know about you and your Academic goals (are you considering continuing to grad school) & Personal goals.(Required)

Up to 350 words

Personal statement essay, please address the following items: 1. Any special family circumstances (e.g., divorce, job loss, illness, debts, etc.) or unusual expense(s) preventing your receiving financial assistance from your parents or otherwise contributing to your current financial need – Why you need assistance; 2. Your involvement with the community, now and in the past; and future. 3. How you see yourself “paying this gift forward” to others in the future if you are awarded this scholarship?(Required)

Up to 500 words

Application Submission

I affirm that the information presented in this application is true, correct, and complete, to the best of my knowledge. I understand that any false or misleading statements on this application may disqualify me. I understand that this is only an application for a scholarship grant and that the awards are recommended and approved by the Fletcher’s Chapel Willard Scholarship Committee.

In the event that I am awarded a scholarship, I authorize the release of personal information, photographs, audio and/or video recordings for publicity purposes. Further, I understand that Fletcher’s Chapel may be required to report information about my Scholarship to the Internal Revenue Service.

Do you agree to the above terms and conditions?(Required)

Yes

In order for your application to be eligible for consideration, you must complete the following:

(1) Submit all supplemental materials to the Fletcher’s Chapel Willard Scholarship Program by the deadline of September 15th and (2) Click on the “Submit” button below. Your application will not be considered by the scholarship committee unless you comply with Items #1 and #2 stated above.

There will be no exceptions!

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