American Board of Funeral Service Education

Undergraduate Scholarship Application

Please print this form, and mail completed form to: Scholarship Committee, American Board of Funeral Service Education, 3432 Ashland Avenue, Suite U,
St. Joseph, MO 64506

ABFSE students are eligible for one scholarship award each calendar year.

Return links to the ABFSE Website are at the bottom of this page.

A. Personal Information
  Name:________________________________________________________
  Permanent Address: Street or Box: ________________________________
  City: __________________________ State: _____ Zip: _______________

  Current Address (if different): Street or Box: ________________________
  City: __________________________ State: _____ Zip: _______________

  Date of Birth: ___________ Place: ________________________________
  Citizenship Status: US______ Other (specify) _______________________

  Marital Status: Married____ Single____ Separated____ Divorced____
  Dependents: (Number and ages) __________________________________
  ______________________________________________________________

B. Parent’s Information (complete only if you are declared a dependent on your parent’s federal income tax form for the last year)

  Father’s Name: _________________________________________________
  Address: Street or Box: __________________________________________
  City: __________________________ State: _____ Zip: _______________
  Father’s Occupation: ____________________________________________
  Name of Firm: __________________________________________________

  Mother’s Name: _________________________________________________
  Address: Street or Box: __________________________________________
  City: __________________________ State: _____ Zip: _______________
  Mother’s Occupation: ____________________________________________

  Other Dependents in Family:
  Name:        Age:   College last year?  Fees paid by parents:
  ______________________________________________________________
  ______________________________________________________________

Note: Applications must be accompanied by one of the following:
If you are declared as a deduction on your parents’ income taxes, you must provide the committee with a photocopy of page 1 of your parents’ 1040 Form for last year.

If you are not declared as a deduction on your parents’ income taxes, you must provide the committee with a photocopy of page 1 of your own 1040 Form for last year.

C. Personal Financial Statement: Explain how you are planning to pay for your Mortuary School education. Be sure to include estimated expenses (i.e. tuition, room and board, etc.) and support (i.e. occupation income, parental support, personal savings, grants and loans, etc.) for the next school year.

Please add a blank page at the end of this application for your response. Be sure to type your response.

D. Spouse’s Information (if applicable)

  Name: ________________________________________________________
  Address (if other than yours): Street or Box: _____________________
  City: __________________________ State: _____ Zip: _______________
  Occupation: ___________________________________________________
  Name of Firm: __________________________________________________

If spouse files a separate tax return, you must provide a photocopy of page 1 of the last year’s return.

E. Educational/Military Background:
  High School             Years attended       Year Graduated
  ______________________________________________________________
  Colleges               Years attended    Major  Year Graduated
  ______________________________________________________________
  ______________________________________________________________
  ______________________________________________________________
  Other educational experiences you consider important for us to know about
  if any (i.e. military, international, etc.):
  ______________________________________________________________
  Military Background (if any)
  Branch               Period of service      Rank obtained
  ______________________________________________________________

F. School and Community Activities:
  School activities         Dates of participation    Hrs. per week
  ______________________________________________________________
  ______________________________________________________________
  ______________________________________________________________
  ______________________________________________________________

  Civic/Church activities     Dates of participation    Hrs. per week
  ______________________________________________________________
  ______________________________________________________________
  ______________________________________________________________
  ______________________________________________________________

G. Funeral Service Education information:
  ABFSE school you are attending: _________________________________
  _____________________________________________________________
  Date your studies there began:___________________________________
  Expected date of graduation:__________ Diploma or Degree?___________

H. Work Experience: list jobs including summer employment
  Job Held   Employer         Dates of Employment   Hrs. per week
  _____________________________________________________________
  _____________________________________________________________
  _____________________________________________________________
  _____________________________________________________________

I. Tell us about yourself (required):
  Tell us why you chose funeral service as a profession. Please include significant experiences and special people that have had an impact on this decision. Please share with the Committee a brief personal history.

Please add a blank page at the end of this response for your essay if necessary.  Be sure to type your essay.

J. Letter of Recommendation (required):
  Submit a typed letter of recommendation from someone other than faculty member or mortuary college official, family member, or friend on appropriate letterhead stationary.

K. College Transcripts (required):
  Submit a copy of transcripts from every college you have attended (even though may not have graduated). At least one of the transcripts must indicate that you have completed at least one complete term of study in funeral service or mortuary science.

L. Federal Tax Form 1040 (required):
  Submit a copy of either: parents’ 1040 if you are declared as a dependent for tax purposes, or your own 1040 if you are not declared as a parental deduction.

M. I certify that the above information is true and can be verified by proper
  documentation, if required:

  Your signature: _______________________________________________
  Date: _______________________________________________________

Mail (faxes will not be accepted) completed form to:
Scholarship Committee
American Board of Funeral Service Education
3432 Ashland Avenue, Suite U
St. Joseph, MO 64506

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