Academic year for which you are applying * Name * First Name Last Name Date of Birth * MM DD YYYY Email * Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Please list the address you will use while attending school, if different from your home address Where did you hear about Missionary Emergency Fund student grants? * Have you applied for a MEF grant before? * Yes No Student's School ID # Degree seeking * Bachelor's Master's Doctoral Name of School * School's Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Name of degree seeking * Length of program * Year in school next year (e.g. Freshman, 2 of 3, etc.) * Enrolled part time or full time? * Part Time Full Time Hours Enrolled * Do you understand that you must maintain at least a C average to be eligible for assistance? * Yes No Are you participating in a course of study designed to prepare you for ministry work? If Yes, you may go to the next section. If No, please complete the parental information * No Yes Name of parent(s) who is either active or retired clergy or missionary Name of parent's employer Parent's type of work Name & position of person completing Christian character reference * Name of church * Church's Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Amount church is contributing toward your educational expenses * Name & position of person completing reference that speaks to your aptitude and potential for completion of program of study * Address of reference * Address 1 Address 2 City State/Province Zip/Postal Code Country Why is assistance from Missionary Emergency Fund necessary? * Amount you are requesting from Missionary Emergency Fund for tuition assistance * Do you understand that in order to be eligible for assistance you must be the child of an active or retired clergyman, clergywoman, or missionary, or your course of study must be designed to prepare you for the ministry, missionary work or related Christian service work? * Yes No Have you received your two references and will you e-mail them to mef@fpcbristol.org before April 15? * Yes No If you are a returning student, have you requested that a certification of academic stating be submitted on your behalf by the appropriate educational institution official? Please remember that while that document does not have to be included with your application, it is your responsibility to assure the form has been received by the MEF office. * Yes No Do you understand that you are responsible for notifying the Missionary Emergency Fund, Inc., of any changes that take place (college/university plan to attend, address changes) between the submission of this application and the opening of the applicable school year? * Yes No By signing below, you authorize the investigation of all matters contained in this application and hereby give Missionary Emergency Fund, Inc., permission to contact your school and your references and hereby release MEF, Inc., from any liability as a result of such contact. By signing below, you state that you are aware that any misrepresentation or omission of important facts and relevant information is just cause for rescinding funds granted to the applicant. By signing below, you certify that you have completed this application and that all information is true and complete to the best of your knowledge (Please type name) * Thank you!
