Application Form
Helena B. Cobb Scholarship Grant
Women’s Missionary Council
Christian Methodist Episcopal Church
Overview of the Helena B. Cobb Scholarship Program
Dr. Elnora P. Hamb, President Bishop L. L. Reddick, III - Patron Bishop
Return To: Mrs. Princess A. Pegues, Vice President
2309 Bonnie Avenue
Bastrop, LA 71220
(Please Print or Type)
DATE___________________________________
_____ First Time Applying _____Receiving & Reapplying _____Reapplying, not Receiving
NAME___ _______Social Security#___________________
Last First Middle
ADDRESS____________________________________________________________________________ ZIP________________
Street City State
TELEPHONE NUMBER__________________________________________DATE OF BIRTH____________________________
PRESIDING BISHOP____________________________________LOCAL CHURCH___________________________________
ADDRESS OF LOCAL CHURCH____________________________________________________________________________
LOCAL CHURCH PASTOR__________________________________________________PHONE #_______________________
LOCAL MISSIONARY PRESIDENT________________________________________________________PHONE #_______________________
ADDRESS_____________________________________________________________________________________________________________
LOCAL MISSIONARY VICE PRESIDENT__________________________________________________PHONE #________________________
ADDRESS_____________________________________________________________________________________________________________
REGION (ANNUAL CONFERENCE) MISSIONARY PRESIDENT__________________________________PHONE #____________________
ADDRESS_____________________________________________________________________________________________________________
SIGNATURE OF REGION PRESIDENT_____________________________________________________________________________________
REGION (ANNUAL CONFERENCE) MISSIONARY VICE PRESIDENT______________________________PHONE #___________________
ADDRESS_____________________________________________________________________________________________________________
SIGNATURE OF REGION VICE PRESIDENT_______________________________________________________________________
COLLEGE/UNIVERSITY ATTENDING: ___Lane College ____ Miles College ___Paine College ___Texas College
OTHER
COLLEGE/UNIVERSITY_________________________________________________________________________________________
OFFICIAL ADDRESS OF
COLLEGE/UNIVERSITY___________________________________________________________ZIP____________
DEGREE SOUGHT_______________________________________CLASSIFICATION____________MAJOR____________________________
DATE OF GRADUATION__________________________________________
ANTICIPATED ANNUAL COST $_____________AMOUNT OF OTHER FINANCIAL AID/GRANTS $_________________
AMOUNT REQUESTED FROM HELENA B. COBB SCHOLARSHIP $____________________________________________
REFERRED BY___________________________________________________________________________
The Women’s Missionary Council of the Christian Methodist Episcopal Church has limited amount of funds; however, the above information is necessary so that the Education Committee can process your application. The Committee meets once a year and the Grants are sent to the College/University in September following receipt of the application. Aid is granted on a yearly basis for four (4) consecutive years; however, applicant must apply or reapply each year. Preference may be given to those attending a CME College/University.
DEADLINE TO SUBMIT IS DECEMBER 31st
|