The South Coastal District of the Wesleyan Church

Please fill out the entire application and submit to South Coastal District Raymond Hicks Scholarship Fund.

STUDENT INFORMATION:
Name:
*
Address:
*
City:
*
State:
*
Zip Code:
*
Email Address:
*
Church Name:
*
Family Status:

Number of Children under 18 in Household

Are you registered with the Wesleyan Church Headquarters Education and Ministry Department as a Ministerial Student?

Are you current with all meetings and paperwork with the District Board of Ministerial Development?

Current Ministerial Status:

FINANCIAL INFORMATION:

Select One
$0 - $25.000
$25001 - $35000
$35001 - $45000
$45001 - $55000
$55001 - or more

REQUEST INFORMATION:
Please briefly describe the main reason that you need assistance with Ministerial Classes:
*

CURRENT MINISTRIES:
Please describe the local church ministries that you are involved in at this time:
*

CLASS INFORMATION:
What Class(es) have you enrolled in
*

CLASS INFORMATION CONTINUED:
Location of Class:

Cost
*

Student E-Signature
*
Date:
*
Security code:
*
Do not enter anything in this field:

* indicates a required field