Name

Email

Address

Phone

Date of Birth(mo/day/yr)

Name of College/University/Trade School

Please answer the following questions:

Major

1. What are your career plans and what influenced your decision?

2. How has your Christian faith influenced your educational/career choice?

3. What is your affiliation with Northminster Presbyterian Chruch?

4. In what activities do you participate outside of school/college?

5. What special academic awards or honors have you received?

List the name of your references, their association to you, and their email and/or phone number.

I attest the above information is true and correct and that I have read the requirements and guidelines for the NPC Scholarship. I attest the above information is true and correct and that I have read the requirements and guidelines for the NPC Scholarship. Yes No

Name and Date