RZIM

SCHOLARSHIP APPLICATION
Scholarships for the RZIM Academy will be awarded based on need and motivation for participation.
We are not able to give full scholarships but may be able to award as much as 80% of the total
cost. Please fill out all the applicable fields and submit your signed application to RZIM by uploading it
on the Scholarship Application page. Thank you for your interest in the RZIM Academy.
Please Print or Type
I. STUDENT INFORMATION
Last Name: ___________________________________________________________
First Name: ___________________________________________________________
Middle Name: ________________________________________ Age ____________
Address: _____________________________________________________________
City: ________________________________ State: _________________
Zip Code: ____________________________ Country: _________________
Email: _________________________________________________________________
Mobile Phone Number: ____________________________________________________
Home Phone Number: ____________________________________________________
Mail Address (if different): _________________________________________________
City: ___________________________________ State: ______________________
RZIM ACADEMY 1
3755 Mansell Road
Alpharetta, GA - 30022, U.S.A.
www.rzimacademy.org
Zip Code: _______________________________ Country: _____________________
Are you affiliated with a church? ____ Name of Church: _________________________
Employed By (if applicable): _______________________________________________
Job Title: _____________________Current Salary: _______ per month (in local currency)
How did you hear about the RZIM Academy? _________________________________
What amount are you able to pay for this course? ______________________________
For which course are you requesting a scholarship? (Please select one):
■ Core Module Islam Elective Faith Seeking Understanding Science
Bible Elective Why Suffering? Engaging the Modern World Core Module: GSC
*Please Note: Only those who have successfully completed the Core Module can apply for a scholarship to enroll in any Elective Module.
II. FINANCIAL AID REQUEST
Please offer a brief description of why you wish to receive a scholarship for the
RZIM Academy.
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RZIM ACADEMY
3755 Mansell Road
www.rzimacademy.org
III. VERIFICATION
By signing this application, I certify that all the information on this form is correct and
complete.
Student: _______________________________ Date: ________________
Printed Name: __________________________________________________
Please note that it may take a few weeks to process your application.
Please contact us for further information or questions regarding this application.
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RZIM ACADEMY
3755 Mansell Road
www.rzimacademy.org

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SCHOLARSHIP APPLICATION

Please Print or Type

Last Name: ___________________________________________________________

First Name: ___________________________________________________________

Middle Name: ____________________________ Age

City: ________________ State: _

Zip Code: ____________ Country: _

Mobile Phone Number: ____________________________________________________

Home Phone Number: ____________________________________________________

Mail Address (if different): _________________________________________________

City: _____________ State:

Are you affiliated with a church? Name of Church: _____________________

Employed By (if applicable): _______________________________________________

How did you hear about the RZIM Academy? _________________________________

Student: _______________ Date:

Printed Name: __________________________________________________

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