ANGLICAN
CHURCH
WORLDWIDE

  Anglican Church Worldwide (ACW)

 Board of Education
Questionnaire
For College Scholarship
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1. Date of Application______________________________________

  

Name ___________________________________________________

Address_________________________________________________

Age of Applicant__________________________________________

Telephone Number     (            )______________________________

E-mail___________________________________________________

  

Parents or Guardian Names:

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How long have you resided at your current address_____________________

 

 2. If not a member of an Anglican Church, please supply 3 names of references along with telephone
     numbers for verification.

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3. Did you graduate from  High School    (Yes)_______       (No)________

    Please give the name of your graduated School

 

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4. Please give a 25 word hand written essay of why you should be considered for a scholarship.

 

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5. Please give a 25 word hand written essay of your educational goals.

 

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6. If accepted for Scholarship Funding, will you be a    part time (         ) 

    or  fulltime (        ) student?

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7. What School do you plan to apply or attend?

 

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8. Is it your intention to complete this Scholarship to its completion should you be approved? 

 Yes  (            )               No (              )

  

9. Please provide a transcript of you former School Record.  This must  be done before Scholarship is granted.

 

Addendum

What would you say is your best subject in High School________________________________________

 

What would you say is your most difficult subject in school_____________________________________

  

How well do you accept your teachers authority?  Very well (    )      Sometimes  (     )      Not at all  (     )

 

Are you ready to accept full learning and discipline responsibility towards your education?   Yes (    )   No (    )

  

Are there any legal issues or litigation (past or present) that will  impede confirmation of your Scholarship?

 (YES_________ )                     (NO___________)

 

 I ______________________________________________________ the undersigned  verify that all information given in this        (Printed Name of Student)              document for scholarship requirements of the ACW Scholarship fund is true to the best of  my ability.

 

 

Signed (Student)

 

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Mail to:

ACW Board of Education
National Chancery, Cathedral of the Good Shepherd
9305 Lebanon Road 
Belleville Illinois 62223 

 

  

 

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