ANNA JENTZSCH-BILL ENDOWMENT BURSARY APPLICATION

This bursary was set up as a memorial trust fund in 1994 with an initial gift of $100.  The fund was subsequently added to with maturing of a significant annuity and the ensuing interest.  Its purpose is to support women in ministry. 
Awards of up to $5,000 will be provided from this fund.
Please submit your completed form by email to scholarships@united-church.ca 

Personal Information:

Name: 
		
Address:

	
Telephone number:
	E-mail address:	

Are you female?  	Yes	No		
Are you in paid accountable ministry?	Yes	No		
Are you a lay, ordained or diaconal minister?	Lay 	Ordained	Diaconal	

What studies, education or professional development are you pursuing and at what institution?	

	
What is your purpose for seeking this educational opportunity? How will it enhance your capacity to provide ministry?	

	
Please state briefly any other information pertinent to your application. For repeat applicants, please provide an update on your studies.	

	
Please indicate how you heard of the Anna Jentzsch-Bill Endowment Bursary Fund.	

	

Please attach two letters of reference supporting your pursuit of this opportunity.

ANNA JENTZSCH-BILL ENDOWMENT BURSARY FUND
STATEMENT OF PERSONAL FINANCES

Name: ______________________________________________________________________________
First Name 					Middle Name 					Last Name
Address: ____________________________________________________________________________
Street 					City 				Province
_____________________________Tel. ____________________________________________________
Postal Code 					Office 					Home

Year of entry into current post-graduate program _____________________________________________

Institution ____________________________________________________________________________

Have you previously been awarded this bursary? Yes ___ No ___

Are you applying for any other scholarships or bursaries? Yes ___ No ___

What other scholarships/bursaries have you received?

I N C O M E
Number of dependents other than self:					__________________________

Net family income from all sources: 					$_________________________

Amount received for housing and transportation, if applicable: 		$_________________________

TOTAL INCOME: 							$_________________________

E X P E N S E S
Housing costs 								$_________________________

Other living costs 							$_________________________

Debt payment 								$_________________________

Estimated study expenses for year of application:
Tuition 			$______________
Other Fees 		$______________
Books 			$______________
Transportation 		$______________  (please state nature)
Research costs 		$______________  (please provide a statement of amount and nature of
any special research costs being required)
Other 			$______________
Total Study Expenses: $______________

TOTAL EXPENSES: 							$_________________________

Amount of Scholarship Request: $____________________

Date: _____________________Signature of Applicant:______________________________________

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