Scholarship Application Step 1 of 2 50% Student's Name* First Last Parent(s) InformationFather's Name First Last Mother's Name First Last Parent(s) Primary Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Parent(s) Primary PhoneParent(s) Primary Email What is your father's employment situation?*Full-time, salaried position with or without benefitsFull-time, hourly position with benefitsFull-time, hourly position without benefitsContract worker (paid by the job)Self-employed / business ownerOn government disabilityReceiving unemployment benefitsStay at home dadWhat is your mother's employment situation?*Full-time, salaried position with or without benefitsFull-time, hourly position with benefitsFull-time, hourly position without benefitsContract worker (paid by the job)Self-employed / business ownerOn government disabilityReceiving unemployment benefitsStay at home momWhat is your family's yearly, before-tax, combined income?*Have you had any financial emergencies this year (large health bill, large bill for home or vehicle repair, etc)?*YesNoWhat was the nature and financial impact of the emergency?How much can your parent(s) contribute towards your tuition at SOULS Northwest during the 2015/2016 school year?Are your parent(s) willing to assist you to fundraise for tuition at SOULS Northwest?*Most students receive some tuition assistance from their church, parent(s) and/or friends and relatives. A simple letter explaining the program and your need can help, and a parent's input into the process can be invaluable. YesNoPlease explain why your parent(s) is unwilling or unable to help with fundraising.* Save and Continue Later Student BudgetWhat was your total, before-tax income last year?*Include any money from relatives and parents as well as payment for any jobs you had.What job(s) have you had in the last year?How much money have you personally spent on the following items in the last six months (to be accurate you should review your bank statements)?Enter "none" if you haven't spent money in a category.Eating out (snacks, fast-food, or a sit-down restaurant)*Groceries (all food other than eating out)*Travel (gas, airfare, etc)*Vehicle expenses (registration, insurance, repair)*Trafic violations*Healthcare (doctor visit, medication, etc)*Entertainment (DVD purchase/rental, music, theater, etc)*Phone / internet equipment and service*Clothes and shoes*Technology (computer, tablet, watch, software, and subscriptions)*Tithe & Offering*Other Charitable contributions*Gifts (birthday, Christmas, friendship, etc)*Education (books, tuition)*Housing (rent, upkeep)*What is the total of your recurring (monthly) expenses?*If you have yearly expenses such as vehicle registration, divide the yearly expense by 12 and include it in your monthly expense.How much, if any, do you expect to pay in upcoming bills during the 2015/2016 school year such as a medical expense or a lump-sum loan repayment?*Put "none" if you don't anticipate any bills. How much can your church contribute towards your tuition in the 2015/2016 school year?*Which of the following expenses will you reduce or eliminate during this school year?* Cell phone / internet Entertainment Eating out Other By signing below I agree to (1) participate in a monthly budgeting meeting with a SOULS staff member, and (2) use a financial management software such as Mint or Mvelopes.Signature* Save and Continue Later This iframe contains the logic required to handle AJAX powered Gravity Forms.