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Debt Reduction Grant Application
Step 1 of 4 - Personal Information
25%
Personal Information
Name
First
Last
Gender
Male
Female
Social Security #
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone
Birth Date
Date Format: MM slash DD slash YYYY
Marital Status
Married
Single
Number of Dependents
Please select the number of your dependents
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Dependents
Please list the names and ages for each of your dependents.
Name
Age
School and Student Loan Information
Seminaries Attended (list present school first)
School
Dates Attended
GPA
Year
Scholarships
Please list any scholarships received while in seminary.
Scholarship Name
Amount Received
Year
Honors and Awards
Briefly list any academic honors or rewards received while in seminary.
Student Loans
List student loans received while in seminary.
Loan Name
Amount
Year
Current Balance
Pre-Seminary Loans
*
Do you have any pre-seminary student loans?
Yes
No
List Preexisting Loans
Please list any preexisting loans.
Institution
Date
Loan Amount
Current Balance
Personal Finances
Applicant Current Annual Income
*
Please enter your current annual income:
Spouse's Current Annual Income
If married, please enter your spouse's annual income:
Car Loan
Do you have automobile loan payments?
Yes
No
Automobile Loan Payment Amount
Please enter the total per month payment amount for your automobile loan(s).
Home Mortgage
Do you have home mortgage payments?
Yes
No
Home Mortgage Payment Amount
Please enter the total per month payment amount for your mortgage(s).
File Uploads & Certification
Please include the following files:
Income Tax Return from Loan Year(s)
Copy of income tax return(s) for the year(s) in which you incurred loan debt while in seminary. (file size limited to 200mb)
Accepted file types: pdf, doc, jpg, png, pages.
Most Recent Tax Return
Copy of your most recent tax return (max upload size 200mb)
Accepted file types: pdf, doc, jpg, png, pages.
Transcript(s)
Copy of seminary transcript(s) (max upload size 200mb)
Accepted file types: pdf, doc, jpg, png, pages.
Student Loan Statements
Copy of your most recent student loan statements (max upload size 200mb)
Accepted file types: pdf, doc, jpg, png, pages.
Certification
*
I certify that, to the best of my knowledge, the information contained in this application is correct and complete.
Signature
*
Please enter your full name.
Signature Date
*
Date Format: MM slash DD slash YYYY
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