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UBC S.A.F.E. Scholarship-H.S. Seniors
STUDENT ASSISTANCE FUND FOR EDUCATION SCHOLARSHIP APPLICATION - H.S. SENIORS

REV. DR. CAMPBELL B. SINGLETON, III, PASTOR - Union Baptist Church of Montclair

Email address *
Personal Information
Name *
Your answer
Home Address *
Your answer
Home Phone # *
Your answer
School Address *
Your answer
School Phone # *
Your answer
Cell Phone # *
Your answer
H.S./Post-Secondary Information
High School *
Your answer
Current H.S. Grade Point Average (GPA) *
Your answer
What colleges/universities have you applied to/been accepted to already? *
Your answer
What college/university will you attend in the fall? *
Your answer
(Anticipated) Course of Study/Degree *
Ex: Bachelor of Arts Degree in Communication
Your answer
Will you be attending full-time or part-time? *
Expected Date of Graduation *
Your answer
List all Secondary & Higher Education Institutions Attended *
Include school name, location and dates of attendance
Your answer
Extracurricular Activities
Each applicant should include three (3) references. (References can not be family members) Include individual's name, title, company/organization and contact information (email/phone #)
Activity #1 *
Your answer
Activity #2
Your answer
Activity #3
Your answer
Activity #4
Your answer
Activity #5
Your answer
Activity #6
Your answer
References
Each applicant should include three (3) references. (References can not be family members) Include individual's name, title, company/organization and contact information (email/phone #)
Reference #1 *
Your answer
Reference #2 *
Your answer
Reference #3 *
Your answer
Essay Responses
Maximum word count 500 words
If you received this scholarship, what would that mean to you? *
Your answer
Additional space for response to question #1
Your answer
Question #2: What are your future career and/or educational goals upon obtaining this degree?? *
Your answer
Additional space for response to question #2
Your answer
Question #3: What past experience has had the most impact on your educational and/or career goals? *
Your answer
Additional space for response to question #3
Your answer
Church Information
Are you a member of Union Baptist Church? *
If neither situation apply to you, indicate N/A in the answer section
Required
Ministry Participation *
List the ministries you have served on at Union.
Your answer
Have you previously received a scholarship? If so what years. *
Your answer
A copy of your responses will be emailed to the address you provided.
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