FIRST TIME APPLICATION
FOR
AWARD
DEADLINE: APRIL 30TH
A
FRIENDSHIP MISSIONARY BAPTIST CHURCH
MINISTRY
Rev. 3/2016 K. Neal
FIRST TIME APPLICATION FOR SCHOLARSHIP
COLEMON W. KERRY, JR. SCHOLARSHIP FUND
FRIENDSHIP MISSIONARY BAPTIST CHURCH
3400 BEATTIES FORD ROAD
CHARLOTTE, NC 28216
STUDENT INFORMATION
Last Name
First Name
MI
Street Address
Sex
City
Phone Number
(
Age
State
Your Email Address (Please Print)
Date of Birth (MM/DD/YYYY)
/
)
High School
/
Graduation Date
Have you been accepted into a
college or university?
YES
NO
If yes, name of
college or university
attending:
Major (If
applicable):
Grade Point Average:
(Non-Weighted)
Do you plan to live on
campus?
YES
Are you approved for
financial aid?
Are you currently
employed?
Zip Code
YES
YES
NO
NO
$
If yes, what is the source of
the awarded aid and the
amount?
Source:
Amount:
$
If yes, list the name of your
NO employer:
Are you a member of
Friendship Missionary
Baptist Church?
How long have you been a
member of Friendship Missionary
Baptist Church?
Please list your Mother’s Maiden
Name:
Please list your FMBC
membership number:
PARENT OR GUARDIAN INFORMATION
Total estimated
cost:
Mother’s FMBC membership
number (if applicable):
- * LIST ONLY IF YOU LIVE WITH THIS PARENT
* Name of Father/Male Guardian
Occupation
Employer
How long at this
employer?
* Name of Mother/Female Guardian
Occupation
Employer
How long at this
employer?
Total Family Income (Annually) –
Please place an “X’ in the box
next to the range of your family’s
income.
Under $20,000
$36,000 – $50,000
$66,000 – $80,000
$21,000 – $35,000
$51,000 – $65,000
$81,000 - $95,000
Applicant’s Signature: _______________________________________________
Over $96,000
Date: __________________________________________
Rev. 3/2016 K. Neal
Colemon W. Kerry, Jr. Scholarship Fund
Policies & Criteria
A. Types of Financial Assistance:
1. The Coleman W. Kerry, Jr. Scholarship Fund will award scholarships and/or grants to
selected applicants who satisfy eligibility requirements. Scholarships will be awarded to
students based on demonstrated need and evidence of outstanding academic
performance. Grants will be given to students based on demonstrated financial need.
2. Loans are not available at the current time; however, the Board of Directors will
periodically reassess the feasibility of making loans to students.
B. Eligibility Requirements:
1. To be eligible for financial assistance, an applicant must have been a member of
Friendship Missionary Baptist Church for one calendar year prior to the deadline date
for applications to be submitted. Also, the applicant must have a record of service
and financial support to the church.
2. High school graduates who are applying for the first time should show proof of
acceptance from a college or university. A recipient must be enrolled or planning to
enroll as a full-time student, as defined as a minimum of twelve (12) semester hours or
nine (9) quarter hours. In addition, first time applicants must have a grade point
average equal to or greater than 2.5 (non-weighted).
3. A recipient must be attending an accredited, post-secondary institution; this includes
community colleges, technical institutions, trade/vocational/professional schools, and
four-year degree granting institutions.
4. Graduate students would not be eligible for financial assistance until such time as the
Board of Directors sees fit to make financial aid available for graduate education.
5. Students awarded scholarships or grants are eligible for a one time renewal
scholarship in subsequent years. To be considered for a one time renewal scholarship,
a student must have a 2.5 grade point average or greater.
6. Eligible applicants applying for renewal must only submit an official transcript,
containing seal or an official signature, of their most recent grade report, (i.e. 1st
semester grades), along with their completed application forms by April 30th to be
considered for financial assistance.
7. First time applicants must complete the required application form and provide the
necessary supporting materials to be considered for financial assistance.
8. These materials must be submitted by April 30 to ensure consideration.
Rev. 3/2016 K. Neal
C. Number & Amount of Awards:
1. The number of scholarships and grants made each year will be based on the funds
available, as determined by the Board of Directors.
2. The amount of financial assistance given to a recipient will be based on the funds
available, his/her financial need, and the cost per term/year at the institution
attended.
3. Eligible applicants are limited to two (2) scholarship awards; one as a first time
applicant and one as a renewal applicant in a subsequent year, as funds are
available.
D. Verification of Application Material:
The Board of Directors, through its official representatives, reserves the right to verify
information submitted in support of an application for financial assistance and to
request additional information when needed.
E. Selection of Aid Recipients:
1. The Board of Directors will make the final selections and approve all recipients of
scholarships and grants.
2. All first time eligible applicants must submit to an interview by Board of Directors.
F. Administration of Scholarship and Grant Funds
Funds awarded to a student will be issued in the name of the institution the recipient
indicates he/she will attend. If a recipient of financial assistance determines that
he/she cannot enroll as intended, he/she must provide written notice to the Chairman
of the Board of Directors no later than ten (10) calendar days before the semester
begins.
ALL ITEMS ARE REQUIRED AND MUST BE SUBMITTED BY THE
APPLICATION DEADLINE OF APRIL 30TH.
ONLY COMPLETED APPLICATIONS WITH ALL NECESSARY ATTACHMENTS WILL BE CONSIDERED.
FAILURE TO MEET ALL REQUIREMENTS CAN RESULT IN DISQUALIFICATION.
Rev. 3/2016 K. Neal
RECOMMENDATION FOR
THE COLEMON W. KERRY, JR.
SCHOLARSHIP
Recommendation: Friendship Missionary Baptist Church Member
Applicant’s Name (Please list below)
________________________________________________
I respectfully request that the following information be provided in order that I might be considered for The
Colemon W. Kerry, Jr. Scholarship offered by Friendship Missionary Baptist Church.
________________________________________________
_________________
Signature of Applicant
Date
Excellent
Good
Average
Fair
Poor
Leadership
Dependability/Reliability
Personality
Ability to relate to others
Personal Decorum
Comment on any of the above and/or other information pertinent to the applicant’s consideration for this
scholarship. Attach additional sheets if necessary. All information you provide will be treated in a confidential
manner.
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
________________________________________________
_________________________________
Reference Name – Please Print
Address
________________________________________________
_________________________________
Reference Signature
Date
Please return the recommendation, in a sealed envelope, to the applicant.
Rev. 3/2016 K. Neal
RECOMMENDATION FOR
THE COLEMON W. KERRY, JR.
SCHOLARSHIP
Recommendation: School Principal, Counselor, or Teacher
Applicant’s Name and Title (Please list below)
________________________________________________
I respectfully request that the following information be provided in order that I might be considered for The
Colemon W. Kerry, Jr. Scholarship offered by Friendship Missionary Baptist Church.
________________________________________________
____________________________________
Signature of Applicant
Date
Excellent
Good
Average
Fair
Poor
Leadership
Dependability/Reliability
Personality
Ability to relate to others
Personal Decorum
Comment on any of the above and/or other information pertinent to the applicant’s consideration for this
scholarship. Attach additional sheets if necessary. All information you provide will be treated in a confidential
manner.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________
__________________________________
Reference Name (Please Print)
Address
________________________________________________
__________________________________
Reference Signature
Date
Please return the recommendation, in a sealed envelope, to the applicant.
Rev. 3/2016 K. Neal
RECOMMENDATION FOR
THE COLEMON W. KERRY, JR.
SCHOLARSHIP
Recommendation: Personal Character Reference
Applicant’s Name (Please list below)
________________________________________________
I respectfully request that the following information be provided in order that I might be considered for The
Colemon W. Kerry, Jr. Scholarship offered by Friendship Missionary Baptist Church.
________________________________________________
_________________
Signature of Applicant
Date
Excellent
Good
Average
Fair
Poor
Leadership
Dependability/Reliability
Personality
Ability to relate to others
Personal Decorum
Comment on any of the above and/or other information pertinent to the applicant’s consideration for this
scholarship. Attach additional sheets if necessary. All information you provide will be treated in a confidential
manner.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________
__________________________________
Reference Name (Please Print)
Address
________________________________________________
__________________________________
Reference Signature
Date
Please return the recommendation, in a sealed envelope, to the applicant.
Rev. 3/2016 K. Neal
Applicant’s Name: ______________________________________________
In the space provided below, write a statement as to why you need this award.
Rev. 3/2016 K. Neal
Applicant’s Name: ______________________________________________
In the space below, please list church, school, and community activities, as well
as any academic and community honors.
Rev. 3/2016 K. Neal
Application Attachments
The following items constitute the Scholarship application package. All items are required and must be
submitted by the application deadline of April 30. Only completed applications, with all necessary
attachments, will be considered. FAILURE TO MEET ALL THESE REQUIREMENTS CAN RESULT IN
DISQUALIFICATION.

Write a statement as to why you need this scholarship in order to continue your post-secondary
education.

List church, school, and community activities and honors.

Submit an official copy of your high school transcript if you are graduating from high school.

If you are already in college, submit an official college transcript containing official seal or signature of
your most recent grade report (i.e. 1st semester grades).

Letters of recommendations from three (3) people. Please include the name, address, and phone number
of each person.

Friendship Missionary Baptist Church member

School Principal, Counselor, or Teacher

Personal Character Reference

Application deadline is April 30th for complete scholarship application package.

APPLICATIONS RECEIVED AFTER THE DEADLINE WILL NOT BE ELIGIBLE FOR
CONSIDERATION.
I understand the requirements, policies, and procedures for applying for the Colemon W. Kerry, Jr. Scholarship.
I certify that all of the required documents and attachments listed above are included with my application
package.
______________________________
Signature
______________________________
Date
Rev. 3/2016 K. Neal