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									                 “Also Touch” Scholarship Program
                          Application Form
                                         COVER SHEET
 Please complete the following sections of the “Also Touch” Scholarship Program Application Form.
 When each section has been completed, please mark the appropriate box below. Submit
 completed applications to alsotouchsp@gmail.com no later than January 31.

         A. RECENT PHOTO                                                                 


         C. EDUCATIONAL ATTAINMENT (TRANSCRIPT ATTACHED)                                 

         D. ESSAY QUESTIONS (ATTACHED)                                                   

         E. LETTERS OF RECOMMENDATION (ATTACHED)                                         

         F. AGREEMENT OF “ASSEMBLIES OF GOD FUNDAMENTAL TRUTHS”                          

By signing below, both the scholarship applicant and ATSP Committee Chair verify that the community
has been informed and fully understands that Scholarship Program funds are to be used only for costs
associated with educational expenses; that there will be no additional funding beyond the authorized
amount; and that funding through the Scholarship Program is not guaranteed. In addition, it is
understood that misuse of funds by recipient and or ATSP Committee may result in immediate
termination of funding to the recipient and/or termination of the scholarship program.

Moreover, both the scholarship applicant and ATSP Committee Chair verify that this scholarship is
needed by the applicant and will positively affect the TFCC and Amlan communities, and that they fully
understand and will fulfill the requirements of the “Also Touch” Scholarship Program should they
receive the scholarship.

________________________________________________                                 ____________
Applicant Signature                                                              Date

________________________________________________                                 ____________
ATSP Committee Chair Signature                                                   Date

I have reviewed this proposal and certify that it is well-written, accurately reported, and the
scholarship applicant has the academic and leadership skills to succeed at Negros Oriental State
University if selected for the scholarship. Furthermore, I am confident in his or her potential for
spiritual growth and development.

________________________________________________                                 ____________
TFCC Pastor Signature                                                            Date
                          “Also Touch” Scholarship Program
                                   Application Form
Please fill out the following application form in English to the best of your ability. You may contact Dwight
and Maria Powery at alsotouchsp@gmail.com if you have any questions about the application itself. The
application form may also be downloaded at www.alsotouch.com/scholarshipprogram.html.

                                        A. RECENT PHOTO
                                           Attach recent photo in the box to the left.

        Attach recent photo             B. BACKGROUND INFORMATION
                                           Name _________________________________________________________
                                                    Last                      First                     Middle
                                           Date of Birth (mm/dd/yy) _________________________________
                                           Age ___________________
                                           Address ______________________________________________________
Contact Number ( ____________) ______________________________________________________________________
Email Address ________________________________________________________________________________________
Mother’s Name _______________________________________________________________________________________
Mother’s Occupation ________________________________________________________________________________
Mother’s highest level of education obtained (please check one)
    Did not complete elementary school
    Elementary school graduate
    Secondary school graduate
    Undergraduate degree __________________________________________________
    Master’s degree, PhD or higher ____________________________________________
Father’s Name _______________________________________________________________________________________
Father’s Occupation ________________________________________________________________________________
Father’s highest level of education obtained (please check one)
        Did not complete elementary school
        Elementary school graduate
        Secondary school graduate
        Undergraduate degree __________________________________________________
        Master’s degree, PhD or higher ____________________________________________
Please list the members in your family currently living in your house:
   1. Name __________________________________________          Age __________________
       Describe current status (school, work, etc.): ______________________________________________
   2. Name __________________________________________          Age __________________
       Describe current status (school, work, etc.): ______________________________________________
   3. Name __________________________________________          Age __________________
       Describe current status (school, work, etc.): ______________________________________________
   4. Name __________________________________________          Age __________________
       Describe current status (school, work, etc.): ______________________________________________
   5. Name __________________________________________          Age __________________
       Describe current status (school, work, etc.): ______________________________________________
   6. Name __________________________________________          Age __________________
       Describe current status (school, work, etc.): ______________________________________________
Socioeconomic status: State the annual income of your father and/or mother, as well as any
additional income your family receives. Provide documentation as an attachment.
Father’s Annual Income: __________________________________________________
Mother’s Annual Income: _________________________________________________
Other, specify: _______________________________________________________________
Other, specify: _______________________________________________________________

TOTAL FAMILY INCOME: __________________________________________________
Intended Course: What course do you intend to pursue? _________________________________________
Why? __________________________________________________________________________________________________
How many semesters of a full course load will it require? _______________________________________
Will this course require you to take classes in the summer?               Yes  No  Don’t know

Academic Transcript: Answer the following questions and provide transcripts as an
Elementary school attended: _______________________________________________________________________
Location: _____________________________________________________________________________________________
Year Graduated: _______________________         Average Grade at Graduation: ______________________
Secondary school attended: ________________________________________________________________________
Location: _____________________________________________________________________________________________
Year Graduated: _______________________         Average Grade at Graduation: ______________________

(Optional: If you have attended a college/university but have not yet finished, give details below.)

College/university attended: _______________________________________________________________________
Location: _____________________________________________________________________________________________
Years Attended: _______________________         Average Grade during Attendance: ________________
Why were you unable to complete your degree? _________________________________________________
Extracurricular Activities: List and describe any extracurricular activities you were involved
in during your high school years (in school or in the community). If more space is needed,
attach a separate sheet.
    1. Activity: ______________________________________________________________________________________
        Description: __________________________________________________________________________________
        How many years were you involved? ______________________________________________________
        How many hours a week? ___________________________________________________________________
    2. Activity: ______________________________________________________________________________________
        Description: __________________________________________________________________________________
        How many years were you involved? ______________________________________________________
        How many hours a week? ___________________________________________________________________

Awards and Recognition: List and describe any awards received at the high school level.
Award or Recognition           Year Awarded                 Year level                Description
                                                         (1st, 2nd, 3rd, 4th)

Hobbies or other Special Interests: __________________________________________________________________
Please answer the following questions on a separate sheet of paper in English. Use the
suggested word count as a guideline. If possible, you should type your responses.

   1. Describe yourself: your likes, dislikes, personality, family background, etc.
      (100 words)
   2. Why is education important to you? (100 words)
   3. If you were to receive this scholarship, what course would you pursue and why?
      What are your future aspirations? (200 words)
   4. Describe one hardship you’ve experienced and what you did to overcome it.
      (200 words)
   5. Name a time when you were a leader in your school or community. Who did you
      lead? What qualities of a good leader do you possess? (200 words)
   6. FOR REAPPLICANTS ONLY: What leadership or work opportunities have you
      taken advantage of since you last applied? In your opinion, how are you more
      of a qualified applicant at this time? (200 words)

Please provide two (2) letters of recommendation as a supplement to your application.
Your recommendations should come from one (1) high school teacher who can speak of
your academic ability and one (1) church leader who can speak of your leadership potential
and spirituality. Letters of recommendation should not come from a relative.

Ask your recommenders to answer the following questions in English using the
Recommendation Form, and attach it with your application:
   1. What connection do you have to the applicant?
   2. What can you say about the applicant’s leadership and/or academic ability?
   3. Why do you recommend (or not recommend) the applicant for this scholarship?
Note to recommenders: Letters should be at least 200 words in length and should not be
reviewed by applicant.

Please review the non-negotiable tenets of faith that all Assemblies of God churches adhere
to. Your signature below certifies your agreement to the following statement and is a
required portion of the application.

I believe:
      1. The Scriptures, both the Old and New Testaments, are verbally inspired of God and are the
          revelation of God to man, the infallible, authoritative rule of faith and conduct.
      2. The one true God has revealed Himself as the eternally self-existent "I AM," the Creator of
          heaven and earth and the Redeemer of mankind. He has further revealed Himself as
          embodying the principles of relationship and association as Father, Son and Holy Spirit.
      3. In the deity of the Lord Jesus Christ. As God’s Son, Jesus was both human and divine.
      4. Man was created good and upright; for God said, "Let us make man in our own image, after
          our likeness." However, man by voluntary transgression fell and thereby incurred not only
          physical death but also spiritual death, which is separation from God.
      5. Every person can have restored fellowship with God through ‘salvation’ (trusting Christ,
          through faith and repentance, to be our personal Savior).
      6. Two ordinances- (1) Water baptism by immersion after repenting of one’s sins and
          receiving Christ’s gift of salvation, and (2) Holy Communion (the Lord’s supper) as a
          symbolic remembrance of Christ’s suffering and death for our salvation.
      7. The baptism of the Holy Spirit is a special experience following salvation that empowers
          believers for witnessing and effective service, just as it did in New Testament times.
      8. The baptism of believers in the Holy Spirit is witnessed by the initial physical sign of
          speaking with other tongues as the Spirit of God gives them utterance.
      9. Sanctification initially occurs at salvation and is not only a declaration that a believer is
          holy, but also a progressive lifelong process of separating from evil as believers continually
          draw closer to God and become more Christlike.
      10. The Church has a mission to seek and save all who are lost in sin. We believe ‘the Church’ is
          the body of Christ and consists of the people who, throughout time, have accepted God’s
          offer of redemption (regardless of religious denomination) through the sacrificial death of
          His son Jesus Christ.
      11. A divinely called and scripturally ordained ministry has been provided by our Lord for the
          fourfold purpose in leading the Church in: evangelization of the world, worship of God,
          building a body of saints being perfected in the image of His Son, and meeting human need
          with ministries of love and compassion.
      12. Divine healing of the sick is a privilege for Christians today and is provided for in Christ’s
          atonement (His sacrificial death on the cross for our sins).
      13. In the Blessed Hope- when Jesus raptures His Church prior to His return to earth (the
          second coming). At this future moment in time, all believers who have died will rise from
          their graves and will meet the Lord in the air, and Christians who are alive will be caught up
          with them, to be with the Lord forever.
      14. The second coming of Christ includes the rapture of the saints, which is our blessed hope,
          followed by the visible return of Christ with His saints to reign on earth for one thousand
      15. A final judgment will take place for those who have rejected Christ. They will be judged for
          their sin and consigned to eternal punishment in a punishing lake of fire.

1   Taken from http://ag.org/top/Beliefs/Statement_of_Fundamental_Truths/sft_full.cfm#1
    16. In the perfect New Heavens and a New Earth that Christ is preparing for all people, of all
        time, who have accepted Him. We will live and dwell with Him there forever following His
        millennial reign on Earth. ‘And so shall we forever be with the Lord!’

I, _______________________________________ , certify that I agree with the above tenets of the
Assemblies of God church and am actively committed to spiritual growth.

                                ________________________________________________        ________________
                                Signature                                               Date

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