Scholarship Application

HPEMBA, Inc.
High Point Education and Missionary Baptist Association, Inc.

HPEMBA, INC.

PO Box 17336, Winston Salem, NC 27116
Executive Secretary's Contact Number: 336-995-8366
Email: gohighpoint@gmail.com
© Copyright. All Rights Reserved

First and Last Name: *

Kind of Diploma *

What is your intended career? *

Annual Income *

Occupation *

Total Gross *

Dates Attended *

GPA to Date *

Mother's Name *

Reference Phone Number *

Your Educational Experience *

Annual Income *

Reference Address *

Names of Dependent Children *

Home Address: *

Hobbies or Special Interests *

Address/City *

Personal statement *

Pastor's Home Phone *

Reference Address *

SAT/ACT Score *

Clubs/Organizations Currently Active or Have Been Active In *

Reference 1 *

DOB/Age: *

Before you begin, click on the WELCOME LETTER link and read it thoroughly. Please be sure to complete all sections and submit all required forms outlined in the Welcome Letter. Applications that are incomplete will not be considered. Thank you for in advance.

Pastor's Name *

Reference Phone Number *

Email: *

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Your Phone Number: *

City/Zip Code *

Address/City *

Extracurricular and/or Community Activities (during HS years) *

Colleges applied to: (List in order of preference). Have you been accepted? *

Church Information *

Occupation *

Proposed field of study *

Online Scholarship Application

Reference 2 *

What is your 5-year plan? *

Are you active in your church's organizations and ministries? If yes, please list. *

Total Gross *

Father's Name *

​​​​​​​​​​​HPEMBA, Inc.High Point Education and Missionary Baptist Association, Inc.

HPEMBA, INC.

HPEMBA, Inc.
High Point Education and Missionary Baptist Association, Inc.