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