FIRST UNITED METHODIST CHURCH EUGENE

1376 Olive Street

Eugene, Oregon 97401

Phone: (541) 345-8764; Fax: 485-5025

eugenefumc@eugenefumc.org

www.eugenefumc.org

SCHOLARSHIP INFORMATION

THE MEMORIAL SCHOLARSHIP

The Memorial Scholarship Fund was established by gifts from the estates of Arnold and Alice Rohm and Jean Barrett, and has been enhanced over the years by other gifts. The accrued interest from the principal fund provides the money for scholarships.

ELIGIBILITY

An applicant must be an active participant of First United Methodist Church. She or he must be enrolled or planning to enroll in an accredited undergraduate institution for vocational study or an institution of higher learning.

ELIGIBLE INSTITUTIONS

Eligible institutions include any public or private accredited post-secondary institution or a vocational technical institution.

SELECTION

The Memorial Scholarship Committee will select the scholarship recipients annually. Selections will be based on church involvement, financial need and academic promise.

AMOUNT OF AWARD

The Memorial Scholarship Committee will fix the amount of the scholarship each year based on an analysis of the available funds and the applicant pool.

AWARD NOTIFICATION

The Memorial Scholarship Committee shall send to the recipients a notice of award, by May 28, specifying the terms. The recipient shall sign and return a copy of the scholarship notice, acknowledging the terms and certifying that the funds will be used only for educational expenses.

DISBURSEMENTS

Checks will be made payable only to the Financial Aid Office of the institution selected by the recipient.

REFUNDS

Refunds resulting from a student's failure to complete a full study period shall be returned to the Fund.

CREDIT HOUR REQUIREMENTS

Recipients shall make satisfactory academic progress in order to be considered for future scholarships.

TERMS OF ELIGIBILITY

Recipient's awards will be for the period of one academic year.

APPLICATION PROCEDURE

1. Interested persons may apply by completing the attached application form.

2. First United Methodist Church must receive all your Application and information items by April 23. Notification of awards will be sent by May 28.

ROHM AND BARRETT MEMORIAL

Scholarship Application

First United Methodist Church, Eugene

Please fill out the following information completely.

Please type or print legibly in black ink. Attach another sheet if you need more room.

Full Name ______________________________________________ Gender: M F

First Name Mid. Initial Last Name

Home Address ______________________________________ City _______________

State _______ Zip _________ Permanent Telephone _____________________

E-Mail Address ________________________________________________________

Student ID # ________________________ Date of Birth ___________________

(Mo/Day/Yr)

Academic Information

College/University You Will Attend in 2009-2010

______________________________________________________________________

Name of School

______________________________________________________________________

Address of Financial Aid Office City State Zip

Academic Classification: __ Undergraduate __ First Year __ Second Year

(in 2008-2009) __ Third Year __ Fourth Year __ Other ___________

Please indicate the academic period(s) you plan to attend:

__Fall quarter/semester __Winter quarter/term

__Spring quarter/semester __ Summer quarter/term

__ Other, please explain: ___________________________

Intended Major/Area of study _____________________________________________

Intended Vocation ______________________________________________________

Anticipated Graduation Date ______________________________________________

Applicant Name: __________________________

List the colleges or universities you previously attended?

	Institution	Location	Degree Program	Degree completed?	Years Attended
1				Yes / No
2				Yes / No
3				Yes / No

If applicable, list your military service:

Church, Community & School Activities

Are you an active participant of First United Methodist Church, Eugene? __Yes __No

Have you received a scholarship from First United Methodist Church previously?

__Yes __No If yes, when?_____________________________________

Please list all church activities and approximate dates including mission trips, youth group, choirs, etc. you are involved in. (Please use an additional page if necessary)

___________________________________________________________________

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

Please list community activities that you have been involved in.

___________________________________________________________________

Please list significant school activities and/or honors.

___________________________________________________________________

Applicant Name: _________________________

Please describe your educational, career, and personal goals.

___________________________________________________________________

If there are any other comments or special circumstances that you would like to share with the scholarship committee, please include them on another sheet of paper.

Financial Information

Total estimated educational costs for 2010-2011(tuition, books, fees) ____________

Total estimated financial aid/grant assistance for 2010-2011 ____________

Total scholarships you have received for the 2010-2011 year ____________

Do you plan to work during the 2010-11 school year? __ yes __ no Hrs/week ______

Annual gross household income ____________

Number and ages of persons dependant on that income ____________

CERTIFICATION

I certify that all information that I have provided is true.

If selected to receive a scholarship, I give permission for a publicity release.

___________________________________________

Signature of Applicant

Please include in your application the following information / paperwork:

a. Transcripts:

High School Seniors: Enclose a seventh semester high school transcript showing grade point average. All other students: Enclose transcripts of your college work.

b. Letters of recommendation:

For first time applicants only: please include 2 letters of recommendation from those who know your background and academic work. (A suggestion is one academic reference and one church or community reference.)

MEMORIAL SCHOLARSHIP

Education Memorial Scholarship Application

FIRST UNITED METHODIST CHURCH EUGENE

SCHOLARSHIP INFORMATION

APPLICATION PROCEDURE

Please fill out the following information completely.

Institution

CERTIFICATION