South Dakota Synod Debt-Reduction Application by ECW97R


									                  South Dakota Synod Debt-Reduction Application
                                   For Clergy

                               Return by September 1, 2012
I wish to make application for Seminary Debt-Reduction Assistance.

Name __________________________________________________________________

Address _________________________ City _________________ State ___ Zip _______

Phone 1 _______________ Phone 2 _______________ E-mail ______________________

I attended ________________________ Seminary/Theological School in ____________
Year of Ordination _____________

My total current Seminary/Theological School loan debt is $ _____________

My monthly payments per month are $ _________

Loan Number _____________________ Name on Loan __________________________

Lending Agency Name & Address __________________________________________


I understand that this amount will be verified through the seminary I attended and that
this request is confidential within the committee.

I also understand that this is a loan. If I remain in the South Dakota Synod for five years
after receiving this loan, the loan will be forgiven.

                                      Signed ________________________________

                                      Date _____________________

  Return completed form to South Dakota Synod, ELCA, Augustana College, 2001 S Summit Ave, Sioux
           Falls SD 57197; or fax to 605/274-4028; or e-mail to


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