MIME-Version: 1.0 Content-Location: file:///C:/9E69C639/ImmanuelLutheranChurchScholarshipApplication2009.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" IMMANUEL LUTHERAN CHURCH SCHOLARSHIP

IMMA= NUEL LUTHERAN CHURCH SCHOLARSHIP

Application Form        =             &nb= sp;            =            Deadline is June 1st

Please print in ink or type answers.

Name: ________________________________________________________________________

Address: ________________________________________________= ______________________

City / State / ZIP: _______________________________________________________________

Phone: ____________________ E-mail Address: _____________________________________

Name of High School: ___________________________________________________________

Date of Graduation: _____________________ (month/year)

Home Congregation: ____________________________________________________________

Address/City/ZIP: _______________________________________= _______________________

Pastor: _______________________________________________________________________

To be completed by the Pastor:

I verify that (student name) _______________________________________________________

is a member in good standing o= f ____________________________________= _Lutheran Church.

Pastor’s signature: ______________________________________________________________

Date: _________________________________________________________________________

Concordia Universi= ty you will be attending:

School year: ___________________________________________________________________

Name: ________________________________________________________________________

City/State: ____________________________________________________________________

Please include the following along with your applicatio= n:

1. Transcripts from previous school year.

2. Commitment Letter

3. Photo

Please return this form to:

Immanuel<= /st1:PlaceName> Lutheran Church

703 26th Ave.=

Canton, Ks 67428-8= 860