FBC Scholarship Fund Application

First Baptist Church • 2709 Monument Avenue • Richmond, VA 23220
(804) 358-5458, x158 • Email address (Smith@FBCRichmond.org)

Application Deadline: May 6, 2012

**APPLICATIONS MUST BE COMPLETED AND SUBMITTED BY MAY 6, 2012.
INCOMPLETE OR LATE APPLICATIONS WILL NOT BE CONSIDERED**

It is suggested that you print a copy of this form and complete it by hand before entering the information online. The online form must be completed in full and then submitted. A partially filled form CAN NOT be saved for future completion.

SECTION ONE: PERSONAL INFORMATION—

  1. Name (Last, first, middle):   Date of birth:

  2. Home phone number:   Cell phone number:

  3. Home address (street, city, state, & zip):

  4. E-Mail Address:

  5. First Baptist Member?  Yes  No  Watchcare          Date received:

  6. If no, do you have a family member who is a member of FBC? List name(s) and relationship below:


SECTION TWO: SCHOOL INFORMATION—

  1. Institution you will be attending or list your two top choices from the schools to which you have applied AND tuition/room & board fees (TR&B):

    Name of institution:    TR&B:
    Name of institution:    TR&B:

  2. Your address at the institution (if now known):

  3. I will live: On campus  Off campus  At home

  4. I will be a: Freshman  Sophomore  Junior  Senior  Graduate student  Seminary student

  5. Expected date of graduation (month/year):

  6. What is your current GPA?

  7. Name and address of institution to which check should be made payable and mailed:

    Student ID number: 
    Name of school:
    Address:
    City, state & zip:
    (If you do not have this information yet, please send it as soon as you know where you are going. If for ANY reason your plans change, please notify Martha Smith immediately.)

SECTION THREE: FINANCIAL INFORMATION—

  1. Your family’s total income (check one): Below $25,000  $25,001-$45,000  $45,001-$60,000
    $60,001-$75,000  Above $75,001

  2. Other family members in college? Yes  No

  3. If yes, please list below:


  4. What will you do to assist yourself financially?


  5. What other anticipated sources of funding will you receive? (i.e. family, loans, scholarships)

    Name:    Amount:
    Name:    Amount:

SECTION FOUR: CHRISTIAN EXPERIENCE—

(Because this is a church scholarship, the FBC Scholarship Team would like to be aware of your Christian experience.)

  1. ALL HIGH SCHOOL SENIORS: Please list and briefly explain your involvement in FBC youth ministry.


  2. ALL COLLEGE, GRADUATE, OR SEMINARY STUDENTS: Forward the link below to someone who can verify your involvement, i.e. Church, Christian organization, Bible study, etc. Please request that they complete the form and submit by May 8, 2011. If for any reason you do not have a reference, briefly explain where you are currently in your Christian experience. Please note that this application is NOT complete without this information.   FBCRichmond.org/scholarship/reference.htm

Thank you for your submission. Print a copy of this form for your records then carefully enter the code displayed below and then click submit.

FBC Scholarship online form (12/8/11)