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Perspectives Scholarship Application
Perspectives Scholarship Application for PCC
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Name
*
Your answer
Date
*
MM
/
DD
/
YYYY
Email address
*
Your answer
Phone
*
Your answer
Occupation
Student
Professional Ministry
Retired
Stay at Home Mom or Dad
Job Seeker
Other:
Clear selection
Name of School or Workplace if applicable
Your answer
If a student, what is your long term goal?
Your answer
Do you wish to receive college credit?
Yes, undergraduate
Yes, graduate
No
Clear selection
Major or Type of Work if applicable
Your answer
How did you hear about Perspectives?
Friend or family
Church promotion
Other
Clear selection
If other, list source of reference
Your answer
Why do you want to take Perspectives?
Your answer
Will you complete a Certificate?
Definitely
Will try
Not enough time
Key readings is my only interest
Clear selection
What might stand in the way of your completing a Certificate?
Your answer
Is there anything else you would like to share about yourself and/or your reason for taking Perspectives?
Your answer
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