Pastoral Debt Reduction Grant Application

Personal Information
Name
First Last
Gender
- Male
- Female
Social Security #
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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
Dependents
Please list the names and ages for each of your dependents.
Name Age

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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

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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).

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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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Name	Age

School	Dates Attended	GPA	Year

Scholarship Name	Amount Received	Year

Loan Name	Amount	Year	Current Balance

Personal Information