Church Scholarship Society Application | Episcopal Church in Connecticut

Contact Information

Name

First

Middle

Last

Your Preferred Pronouns

They/Them, She/Her, He/Him, etc.

Date of birth

Address

City

State/Province

Zip/Postal

Country

Email

Note: all communications regarding the scholarship application will be sent to this email address.

Phone

Income & Savings

Total estimated annual family income

$

including wages, investment income, etc.

Total estimated savings

$

Is anyone dependent on you for financial support?

Yes

No

Describe the circumstances of this financial dependence.

How are you presently supporting yourself?

Educational Information & Costs

Name of seminary or program of theological education you will be attending.

Estimated educational expenses before financial aid or support

$

e.g. books, tuition, fees, and other items directly related to your academic program.

Estimated other expenses before financial aid or support

$

e.g. housing, medical expenses, etc.

Total estimated expenses

$

Debt

Indicate your current debt and the estimated amount of each.

Consumer (credit cards, auto loans)

$

Mortgage

$

Student loans

$

Medical

$

Tax

$

Other

$

Total estimated debt

$

Financial Assistance

Indicate anticipated financial assistance and the estimated amount of each.

Parish Support

$

Other Scholarships

$

Loans

$

Family Support

$

Other

$

Total anticipated financial assistance

$

Church Scholarship Society request

Total amount requested from Church Scholarship Society

$

File Uploads

Completed W-9

Maximum file size: 1MB

Completed ACH

Maximum file size: 1MB

If, after pushing the “Submit” button, you receive a message that “your entry was marked as spam” and you were unable to complete your submission, please select “Save Draft” and then contact the Rev. Stacey Kohl at skohl@episcopalct.org for additional assistance.