Application for Assistance
Fifth District Economic Development Fund, Inc.
 
The African Methodist Episcopal Church, Fifth District Economic Development Fund, Inc., a voluntary program, is dedicated to assisting members of the Fifth District in various ways - Education is one of those ways.
 

"Where there is Vision, the people prosper."
   
I.  Application and Plans  
Full Name * Today's date
Permanent Address Phone Number at this Address
Temporary Address (If different) Phone Number at this Address
Place of Birth Age
I am applying for admission as a US Citizen ?
Name of Institution
Social Security Number *

II.  Previous Education
I am applying for the Term of
My grade point average is (ATTACH OFFICIAL TRANSCRIPT)
What was your field of concentration?
Can the course of study be obtained in an A.M.E school ?

List any honors you have received in the college:

    
III.  Employment History
Please list three previous full time employment positions beginning with the most recent position.
          
Place of Employment Position / Title Dates Approximate Income
1) to
          
         
IV. Family Status

Father
Name
Address
Living ?
Appr. Annual Income
Phone
Occupation
       

Mother
Name
Address
Living ?
Appr. Annual Income
Phone
Occupation
       
       
Please give the contact information of the person to be contacted in emergency.
Name
Address Phone
V.  Religious Affiliation
Are you a member of the A.M.E. Church?
What A.M.E. Church are you a member of?
Would you be willing to serve at least two (2) years in an A.M.E. Church?

VI.  References
Please supply the names of three person who are able to give a recent evaluation of your academic,professional,and personal capabilities. Suggested references are: professors, your home pastor, a minister other than your home pastor, a lay person or a business associate. A LETTER OF RECOMMENDATION FROM THE PASTOR OF YOUR CHURCH MUST BE SUBMITTED TO:
 
Fifth District Economic Development Fund, Inc.
4144 Lindell Blvd. Suite 216
St. Louis, MO 63108

VII.  Autobiography
Please write an autobiographical essay in which you address the items listed below. The essay should be approximately five pages in length.If there is other information you believe the Scholarship Committee needs to know, please include it.
 
Regarding your relationship with the church:
  Indicate your most significant involvements and experiences in the church.
  Indicate which present church involvements are most important to you and why.
 
   
 
Regarding your personal history:
  Which experiences and personal relationships have been most formative in
  your personal development?
  What present activities and relationships are most important to you?
 
   
 
Regarding your intellectual interest:
  What issues are of the most concern to you?
  List the three most challenging books you have read , and for each indicate what
  was significant about it for you.
 
   
 

VIII.  Pre-Admission Interview

The Board of the Economic Development Fund reserves the right to request an interview with all applicants. The Scholarship Committee or a representative of the Committee will be participating in the interview process.


  

* Indicates Required Field.