Senior Application

High School Profile

Application for the BCCG Scholarship

Name*
Prefix First Last
Member of Berean Christian Church Gwinnett?*
- Yes
- No
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Phone
Email
Birthdate*
MM
DD
YYYY
Current High School
Number of Years Attended*
Graduation Date
Parent's Email
Briefly share your educational and professional goals and objectives
Plans after high school (e.g. name of college, military. If college, course of study.
High School Profile Photo Uploads*
Drop files here or

Scholarship

Application for the BCCG Scholarship

Name*
Prefix First Last
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Phone
Email
Birthdate*
MM
DD
YYYY
Current High School
Number of Years Attended*
List Colleges/Institutions to which you have already applied:
I will be attending the following school in the Fall of 2023*
Proof of acceptance or current student enrollment from the above school is required prior to receipt of funds.
Grade Point Average (GPA)*
On a 4.0 scale Attach proof of GPA. You most recent official school transcript required
ACT or SAT Score*
A copy of your ACT or SAT score is required
Mother's/Guardian's Name
Prefix First Last
Mother's/Guardian's Address
Street Address Address Line 2 City State ZIP Code
Mother's Phone
Father's/Guardian's Name
Prefix First Last
Father's/Guardian's Address
Street Address Address Line 2 City State ZIP Code
Father's Phone
What area/specialty do you plan to major in as you continue your education?
Please list the Berean Gwinnett ministries in which you have participated:
Ministry Role Dates of Service
Please list all high school activities in which you have participated:
Activity Role Dates of Service
Please list extracurricular activities in which you have participated
Organization Role Dates of Service
Briefly share your educational and professional goals and objectives
Awards, honors, and special recognitions
List your awards, honors, and special recognitions you received while in high school.
Spiritual Enrichment
Please explain how you plan to continue your spiritual enrichment while pursuing higher education.
Statement of Accuracy (Signature of Applicant)
Prefix First Last
I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that my picture may be taken and used for any purpose deemed necessary to promote the Berean Christian Church Gwinnett Scholarship Program. I hereby understand that if chosen as a scholarship winner, I must provide evidence of enrollment/registration at the post-secondary institution of my choice before scholarship funds will be awarded.
Date
Scholarship File Uploads
Drop files here or

Order Request Form

Ministry*
Ministry Coordinator*
Ministry Email Address*
Contact Phone*
Area Leader*
Store/Vendor*
Website
Please enter a valid Website URL (e.g. http://www.website.com).
Date items needed by*
Items Requested
Please list the items that you would like to purchase.*
Please include details such as quantity, color, price, sku numbers, etc. to be sure we order the correct items.
File Upload
Drop files here or
Upload any images of product to assist with finding the items your are requesting.
FOR OFFICE USE ONLY
Area Leader Approval
Signature

Assistance Requisition

Gwinnett

Date
Voucher Type*
- Check Voucher
- Credit Card Voucher
- (For Finance Use Only)
Department*
DESCRIPTION
ACCOUNT#
TOTAL AMOUNT
Final Total Amount
PAYABLE TO
Mailing Address
City
State
Zip
Payment Type
- Mail Check
- Pick Check Up
- Credit Card
ALL RECEIPTS MUST BE ATTACHED FOR CREDIT CARD AND REIMBURSEMENT VOUCHERS.
Upload File
Drop files here or
Comments
Note: Please allow a 5-7 day turnaround
Prepared by*
Date
- OFFICE USE ONLY
- Area Ldr/Dpt Hd
- Date
- Approved by
- Date
- Intake Specialist Approval
- Date
- Grant Manager Approval
- Date
- Senior Pastor Approval
- Date
- Finance Department Approval
- Date

High School Profile and Scholarship Portal

Application deadline is extended to May 13, 2022 (no later than 5:00 pm)

Senior Profile Form

Scholarship Application

High School Profile

Scholarship

Order Request Form

Items Requested

FOR OFFICE USE ONLY

Ministry Activity Request Form

FOR OFFICE USE ONLY

Volunteer Information Form

CHRISTIAN EXPERIENCE

BACKGROUND & PERSONAL INFOMATION

REFERENCES

FOR OFFICE USE ONLY

Assistance Requisition

OFFICE USE ONLY

BEREAN GWINNETT CHURCH

Ministry	Role	Dates of Service

Activity	Role	Dates of Service

Organization	Role	Dates of Service

Name	Phone	Relationship Type