Salutation:
Mr.
Ms.
Mrs.
Last Name:
First Name:
Middle Name:
Social Security Number:
(All numbers - No dashes or spaces please)
Permanent Home Address:
Address Line 1:
Address Line 2:
City:
County:
State:
ZipCode:
Phone Number:
Student Email Address:
Parent Email Address:
High School:
City:
State:
ZipCode:
Intended Major(s):
Will you be applying for need based aid (FAFSA)?:
Yes
No
Housing Status:
On - Campus
Off - Campus (Independent student)
Commuter (Living with parents)
Thiel College makes special recognition scholarships and other merit awards based upon a range of criteria, including
adacemic performance; leadership; involvement in student activities, organizations and performing arts; church and/or
youth ministry participation; and community service.
Please detail below your significant accomplishments and/or activities over the last four years. Indicate the time
period of each achievement, activity or recognition (e.g.,"Honor Roll- all four years of high school" or "School Newspaper
-junior and senior years").
Academic awards, honors and leadership positions:
Leadership positions, both in and outside your high school:
Student activities, clubs, sports and organizations at your high school:
Community service activities:
Participation in church or youth ministries:
Specific Information
Some scholarships have very specific requirements. If you want to be considered for one of these and meet one of the following criteria, please provide the appropriate information.
Active member of ELCA congregation (please specify):
Parent who is an active pastor in ELCA church
Parent who is an active pastor in other (non-ECLA)church
Parent, grandparent or sibling member who
is an alumnus(a) of Thiel College (please specify):
Have a sibling currently attending Thiel College on a full-time basis.(Name):
