Application Form - Scholarship Grant

Eagle Scholarship Application Form
In order for the recipient(s) of the scholarship to be identified, the four questions below were designed. The purpose is to allow you to share your desire and need for the scholarship. The information will be kept confidential, only to be reviewed by the selection committee. Please answer each question in 100 words or less.
I. Personal Data:

Tell us about yourself
Full Name *

First Name Last Name
Mobile No. : *

Area Code Phone Number
E-mail : *
Where the confirmation will be send to
Home Address : *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
1. Are you receiving any scholarships or sponsorships for the CAMS Program?

Yes No
If Yes, how much are you receiving and from whom?
2. Please establish your need for the scholarship. What is the number of dependents in your family and your Adjusted Gross Income? Please provide any additional information that will help establish your need for the scholarship.
3. How will your CAMS training benefit you other than to prepare you for licensure?
4. Are you a committed person? Provide examples as to how you are committed to your family, your ministry and your church.
5. What would this scholarship mean to you?
Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application.

I understand if I am awarded the Eagle Scholarship, I am giving my permission for my name and photos to be used in promoting future scholarships.

When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature: *
Should be Empty:

Eagle Scholarship Application Form

I. Personal Data:

Applicant's E-Signature