Charles W. Colson SCHOLARSHIP Application

CHARLES W. COLSON Scholarship Application Wheaton College Billy Graham Center

Wheaton College, IL
ELIGIBILTY CRITERIA

Applicants must:
- Be a Christian
- Be a U.S. Citizen
- Have a felony record
- Felonies MUST NOT include a sexual offense, arson or repeat violent offenses.
- Be out of jail or prison for at least one full year by April 1
- Be established in a local church
- Possess a high school diploma or GED
- Apply to Wheaton College
- Be accepted to Wheaton College Undergraduate or Graduate
- Undergraduate students must be able and willing to move to Wheaton, IL
ADMISSION DEADLINE: January 30 of the academic year.
PRINT FORM OPTION: We recommend printing a copy of this form in advance to help you prepare all the information needed. To print this form, scroll down to the end of the form and press the "print" option.

SAVE FORM OPTION: This application has many sections and you may not be able to complete it in one sitting. If at any time you want to save and continue filling out the application later, scroll down to the end of the form and press the "save for later" button.
CHARLES W. COLSON SCHOLARSHIP APPLICATION
THE FOLLOWING CHECKLIST HAS BEEN DESIGNED TO HELP YOU COMPLETE THE APPLICATION THAT FOLLOWS.

1. Complete your application including
- Application form
- Essays
- Recommendations - Friend, Professional & Pastor
- Incarceration Information/Release (if applicable)
- Parole Release (if applicable)
2. Request education documents:
- High School transcript or GED certificate
- College Transcripts (if applicable)
PERSONAL DATA:

Tell us about yourself
Legal Name*

First NameMiddle NameLast NamePreferred first name
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mobile No. :*

Area CodePhone Number
E-mail :*
Where the confirmation will be sent to
Please re-type your email:*
Where the confirmation will be send to
Sex at Birth:*

MaleFemale
Date of Birth:*

MonthDayYear
Social Security Number (Numeric - No Dash Marks)*
Driver's License Number:
State Issued:

Street Address

Street Address Line 2

CityState

Zip Code
Race & Ethnicity (optional):

American IndianAlaska NativeNative HawaiianPacific IslanderAsianBlack or African AmericanHispanico/LatinoWhite or Euro AmericanOther
Are you a US citizen?*

YesNo
Marital Satus:
If children, list names and ages:
MILITARY SERVICE
Branch:
Years:
Type of discharge received:
EDUCATION:
High School Attended:
Street Address

Street Address Line 2

CityState

Year graduated
Did you graduate?

YesNo
If you did not graduate, do you have a GED?

YesNo
Date passed GED:

MonthDayYear
Date
List any accredited college/universities you have attended
EDUCATIONAL PLANS:
What is your intended major if accepted?
EMPLOYMENT HISTORY:
Please provide the most recent job history
CHURCH/MINISTRY INVOLVEMENT:
Name of Church you presently attend*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Describe any ministry/volunteer involvement you have had at this church.*
AUTOBIOGRAPHICAL INFORMATION:
Have you accepted Jesus Christ as your personal savior?*

YesNo
Statement of Faith: Describe your spiritual journey (coming to faith in Christ and evidence of Christian growth while incarcerated and since release). (3-4 paragraphs)*

0/250
Statement of Career Goals: What are your career goals and how will furthering your education at Wheaton College assist in meeting your goals?*

0/100
RECOMMENDATIONS:

In the fields below, please provide contact information for: FRIEND, PROFESSIONAL AND PASTOR recommendations. Each person will receive an email with a confidential electronic recommendation form from Correctional Ministries Institute.
I, hereby voluntarily waive my right of access to any information contained on the recommendations from the individuals listed below and agree that the statements shall remain confidential. (Initials)*
Friend Recommendation

Please provide name and email address
FRIEND NAME

First NameLast Name
FRIEND EMAIL*
example@example.com
Professional Recommendation

Please provide name and email address
PROFESSIONAL NAME

First NameLast Name
PROFESSIONAL EMAIL*
example@example.com
Pastor Recommendation

Please provide name and email address
PASTOR NAME

First NameLast Name
PASTOR EMAIL*
example@example.com
INCARCERATION INFORMATION:
Statement of Incarceration: Describe your a.) path to incarceration, b.) illegal act (s), c.) impact on victims and, d.) how you have changed.

0/250
I was incarcerated in the following correctional institution(s):
Institution Name:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of incarceration:

MonthDayYear
Date
Felony Offense (s):
Institution Name:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Incarceration:

MonthDayYear
Date
Felony Offense (s):
Institution Name:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of incarceration:

MonthDayYear
Date
Felony Offense (s):
Institution Name:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of incarceration:

MonthDayYear
Date
Felony Offense (s):
I, hereby grant Wheaton College the right to contact administrators of the institutions(s) above and/or conduct a criminal background check confirming my incarceration. (Initials)
PAROLE INFORMATION (if applicable):
I am currently on parole or probation in the state of

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Until:

MonthDayYear
Date
Parole/probation officer:

First NameLast Name
Phone Number

Area CodePhone Number
Explain how a move to the state of Illinois will affect parole/probation conditions
I, hereby grant permission for the Correctional Ministries Institute staff to speak with my parole/probation officer.(Initials)
COMMUNITY COVENANT
Please read Wheaton’s Community Covenant. The covenant is designed to express the crucial Christian convictions, aspirations, commitments and responsibilities shared by the members of the Wheaton College campus family. In applying for membership in this community, you should therefore weigh carefully whether these convictions, aspirations and commitments match your own, and whether you can gladly join in fulfilling the covenant’s responsibilities.

“I affirm by my signature below that I have carefully read Wheaton’s Community Covenant, that this covenant expresses my own Christian convictions, aspirations and commitments, and that, if I am accepted and subsequently enroll as a student at Wheaton College, I will gladly join in fulfilling its responsibilities. (Please explain any questions, reservations or disagreements in an attached statement.)”

“I also affirm by my signature that all the information contained in my application, including my essays, is my own work, factually true and honestly presented.”
Name*

First NameLast Name
Signature*
Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:*
Wheaton College is committed to equal opportunity in employment and education. The College does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

CHARLES W. COLSON Scholarship Application Wheaton College Billy Graham Center

CHARLES W. COLSON SCHOLARSHIP APPLICATION

PERSONAL DATA:

MILITARY SERVICE

EDUCATION:

EDUCATIONAL PLANS:

EMPLOYMENT HISTORY:

CHURCH/MINISTRY INVOLVEMENT:

AUTOBIOGRAPHICAL INFORMATION:

RECOMMENDATIONS:

Friend Recommendation

Professional Recommendation

Pastor Recommendation

INCARCERATION INFORMATION:

PAROLE INFORMATION (if applicable):

COMMUNITY COVENANT

Applicant's E-Signature