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1 National Missionary Auxiliary Louisville, KY The Evangelist Essie Belton Memorial Scholarship And by knowledge shall the chambers be filled with all precious and pleasant riches (Prov. 24:4) Application Form ABOUT THE SCHOLARSHIP CRITERIA FOR SELECTION Applicant must be 21 years old or older Must be a member of the National Missionary Auxiliary and Pentecostal Churches of the Apostolic Faith Must be in good standing with the church and desire to continue to live up to the Apostolic values and doctrine instilled by the church Must have a verified need for financial assistance Must demonstrate a true desire for higher educational success Must have a GPA of at least 2.8. Exceptions may be considered on a case by case basis. APPLICATION PROCESS Fill out the entire application below, with the following signature: signature of candidate Include the following with the application: an essay (Turn to page 5 for details) a sealed letter of recommendation high school transcripts and college transcripts a 4 by 6 headshot photo Page 1 The Bishop James O. Franklin Memorial Scholarship

2 Page 2 BIOGRAPHICAL INFORMATION First name: Middle name: Last name: Preferred name: Date of birth: MM DD YY Gender Home address: City: State zip code Home phone: Other phone: COMMENTS

3 Page 3 SPIRIT Below are some characteristics that have been identified as qualities of spirit. Please check any that apply to you. Creativity Perseverance Innovative thinking Risk-taker Persistence Courage Entrepreneurship Leadership Fearlessness Dreamer Doer Achiever who goes against the odds Rising above circumstances to accomplish something extraordinary Other

4 Page 4 ACADEMIC INFORMATION List the high school and college you have attended. If your school did not have a GPA system, please estimate your current GPA on a 4.0 scale. Grade point average: College or university you plan to attend (List top three in order of priority do not abbreviate

5 Page 5 APPENDICES Provide the following documents and materials as appendices to this application: 1. ESSAY Write an essay about specific qualities and experiences that make you feel deserving of this scholarship (Maximum 750 words). The essay must be typed, double-spaced, and signed and dated by the applicant and their senior pastor. 2. LETTER OF RECOMMENDATION Provide a letter of recommendation written by your senior pastor, assistant pastor, or mission leader that describes why you are nominated for the Dr. Lula Sullivan Scholarship. The writer should describe your personal qualities, your commitment to missions and desire for pursuing higher education, and characteristics that make you a worthy recipient of this award. 3. ACTIVITIES/COMMUNITY SERVICE/AWARDS List and explain your top three extracurricular activities, your top three community service or volunteer activities, and any awards and honors received during your lifetime (maximum 400 words per topic). The list must be typed, double-spaced, and include your signature and senior pastor. 4. PHOTOGRAPH Attach a recent color 4 by 6 head shot photo. Staple the photo in the upper right-hand corner of the application. Put the staple on the very top of the photo and not on the image. Write your complete name on the back of the photo. 5. TRANSCRIPTS Attach your official school transcripts to the application 6. SIGNATURES Complete the signature process on the next page.

6 Page 6 SIGNATURES Applicant Signature I certify that all of the information submitted in support of my application is complete and accurate to the best of my knowledge. I understand that false information will result in termination of the scholarship, if granted. Applicant Signature Date Senior Pastor Signature I certify that the information provided by the applicant is complete and accurate to the best of my knowledge. I understand that false information will result in termination of the scholarship, if granted. Senior Pastor Signature Date Scholarship office use only This scholarship request was Declined Awarded Amount $ Director s signature Date 2010 Other official signature Title

7 Page 7 CHECKLIST Please check the boxes below to make sure that you have included all of the required materials before mailing: Signed application form Photograph Essay Sealed letter of recommendation Official school transcripts Activities/community service/awards information APPLICATION MAILING Applications must be postmarked by June 30, Incomplete applications will not be accepted. Mail completed application in a 9 by 12 envelope to: FOR MORE INFORMATION Contact: Pastor Anita M. Stone Mt. Zion Apostolic Church 4900 East 38 th Street Indianapolis, IN extension 13 acalltomissions@gmail.com

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