Fillable Application 2021 Antiochian Orthodox Christian Archdiocese of North (Microsoft)

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Application 2021 Antiochian Orthodox Christian Archdiocese of North (Microsoft)

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Antiochian Orthodox Christian Archdiocese of North America
Francis Maria Scholarship
Application 2021
Awards of $5,000 each
Send completed application to: Kathleen@OrthodoxYouth.com
Or
Francis Maria Scholarship
Antiochian Archdiocese Scholarships Director
PO Box 389
Westwood MA 02090-0389
CHECKLIST
(This page is for applicant’s use only. Do not send.)
Application Instructions: Complete the following pages A, B, C and provide all requested materials.
Incomplete applications will not be accepted. Print on only one side of the page and only use the pages
provided. Do not send resumes, photos, or letters of recommendation. Give Form D, Pastor’s Evaluation
Form, to your Priest to fill out and mail. All materials must be postmarked by May 15
th
and received no
later than May 21
st
.
Include the following material:
Student and Parent Information Form (Form A) Fill out the financial section – showing total income
for both parents. This form must include all 3 signatures.
Church and School Activities Form (Form B)
This is an important part of your application.
Short Essay (Form C)
The Essay is your opportunity to tell us about your faith and how you would impart your teen experience
to others. The Essay must not exceed 3,000 Characters or one single-spaced page.
Pastor’s Evaluation Form (Form D) The Pastor’s Form must be signed and sent separately and
directly from the Pastor of your parish. Give him adequate time to fill out the form, checking to ensure the
deadline is met. (If applicant is the son or daughter of the Pastor, please have Form D filled out by your
Father Confessor or another Orthodox Priest.)
Grades and Test Scores
Have your High School send your official, signed, and sealed transcripts directly to the Francis
Maria Scholarship Committee. Please be sure they include your SAT or ACT Scores. Canadian
students who have not taken the SAT or ACT scores are exempt from this requirement.
College students must send College and High School transcripts and SATs and/or ACT Scores.
Send your completed Application to: Kathleen@OrthodoxYouth.com or
Francis Maria Scholarship, Antiochian Archdiocese Scholarships Director, PO Box 389,
Westwood MA 02090-0389
Do not send your application by overnight, registered, or certified mail. We only look at the
postmark on the envelope to decide if your application is on time.
Do not staple or fold your application. Print one-sided only.
For questions on this application: E-mail Kathleen@OrthodoxYouth.com or call: 617-240-3321
1
MARIA SCHOLARSHIP
Print Applicant’s Name ________________________________________________
STUDENT AND PARENT INFORMATION FORM
(Form A)
▼To be filled out by the applicant▼
Father’s Name:
Father’s Occupation:
Mother’s Name:
Mother’s Occupation:
Please type or print clearly. All the above information is required, including your e-mail address.
Name of the College you are attending or plan to attend:
Year in college you will be in this coming fall: Freshman Sophomore Junior Senior
What Academic Degree are you working on this fall?
What is or will be your declared major?
I attest that all the information contained in this application is accurate and true:
Applicant’s Signature: Date:
▼To be filled out by the applicant’s Parents/Guardians▼
Confidential Financial Summary to be completed by Parent or Guardian. Please note total salaries of
both parents before taxes by checking the category below. Please use the “total income” not the
“adjusted income” line from your Federal Tax Forms.
I attest that all the information contained in this application is accurate and true:
Parent’s Signature: Date:
Print Parent’s Name:
Parent’s Signature: Date:
Applicant’s Name:
Date of Birth: Male Female
Home Address: Phone Number:
City: Province/State: Zip/Postal Code:
Country: E-Mail address:
Citizenship: USA Canada You must be a U.S. or Canadian Citizen to apply
Total Combined Income for both Parents
Less than $49,999 $50,000 - $79,999 $80,000 - $99,999 $100,000 - $149,999
$150,000
–
$179,999 $180,000 - $249,000 $250,000
–
$499,999 Over $500,000
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2
Print Parent’s Name:
MARIA SCHOLARSHIP
Print Applicant’s Name ________________________________________________
CHURCH AND SCHOOL ACTIVITY FORM
(Form B)
Church and Youth Group Activities for the last four years only:
Church or
g
anizations involved in Offices Held Years Office held
Church activities/events participated in What was your
role?
Years of
Participation
High School, Civic and College Information for the last four years only:
School or
g
anizations involved in Offices Held Years Office held
3
MARIA SCHOLARSHIP
Print Applicant’s Name ________________________________________________
SHORT ESSAY
(Form C)
Maria Essay 2021 – The Antiochian Orthodox Christian Archdiocese Youth Programs support youth to live the
Orthodox Faith in Christ. This Youth Movement encourages full participation in the life of the Church through
Worship, Witness, Service and Fellowship. Using a Scriptural verse that is meaningful to you, describe Christian
leadership abilities you gained through your home parish events and/or diocese and archdiocese programs.
What personal characteristics do you possess that have allowed you to strengthen your relationship with Christ?
Please write a one-page statement describing how you seek to exemplify these values and instill them in others
through your own leadership. Essay must not exceed 3,000 characters, which must fit on this one page.
4
MARIA SCHOLARSHIP
Applicant’s Name:
Name to be filled out by the Applicant.
PASTOR’S EVALUATION FORM
(Form D)
▼To be filled out by the Pastor▼
Dear Father,
The Frank Maria Scholarship Committee appreciates your efforts in completing this evaluation as part
of the Applicant’s Scholarship Award Application. Please note that the completed Pastor’s Evaluation
Form must be postmarked by May 15
th,
2021 and the Pastor must send it to:
Kathleen@OrthodoxYouth.com
Or
Francis Maria Scholarship
Antiochian Archdiocese Scholarships Director
PO Box 389
Westwood MA 02090-0389
Church Community areas of participation and leadership positions:
SOYO
CHURCH SCHOOL
CHOIR/CANTOR
HUMANITARIAN EFFORTS
OTHER
Please write your personal comments and recommendation:
Applicant is a member of Antiochian Orthodox Church.
Church City: Church State/Province:
Print Pastor’s Name: Date:
5
Pastor’s Signature:
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Application 2021 Antiochian Orthodox Christian Archdiocese of North (Microsoft)

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Completed 29 April 2021

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