NOTES TO STUDENT Student's District
SECTION I: To be completed by Student.
with parents Single Divorced Self
on-campus Married Spouse # of Children
Yes No
(or his/her representative): _________________________________________________________ ____________________
SECTION III: To be completed by the District.
Amount of District Aid Approved: ____________________
Street Address:
Social Security No:
1) Contact your district office for additional information that may be required and necessary to process
2) Upon Completion of Section I of this application, print, sign by you and your pastor
, and send to the
Financial Aid office of the Concordia college/university or seminary you choose to attend.
Telephone No:
The Lutheran Church-Missouri Synod
Last Name: First Name & Middle Initial:
Total number of dependents:
Date of Birth:
Month/Year Month/Year
Major Course of Study: Church Work Vocation:
Period when you will use aid:
Do you intend to enter full-time church work?
Home Congregation/City:
Your Signature:**
Pastor's Signature:Pastor's Name:
City, State, Zip:
Marital Status:
E-Mail Address:
**The Financial Aid Officer has my permission to share with the District any need analysis information contained in my financial aid files.
SECTION II: To be completed by College/University or Seminary and forwarded to the District Financial Aid Officer.
Unmet Need
Period of District Aid:
Name of Institution:
Estimated Cost of Education Estimated Gift Aid
For Award Period
Student Grade Level:Address:
City, State, Zip:
revised 05/07/10
Authorized Signature: ______________________________________
While in school you intend to live:
I certify that this student is accepted for enrollment, or is enrolled and in good standing and is making satisfactory progress.
Signature of Financial Aid Officer Date:
Expected Contribution
Reset Form
your application. Most Districts require the FAFSA be filed before consideration for a scholarship.