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 Elective

Bible Elective Why Suffering? Engaging the Modern World Core Module GSC

Human Elective

*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.

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RZIM ACADEMY
3755 Mansell Road
Alpharetta, GA - 30022, U.S.A.
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
Alpharetta, GA - 30022, U.S.A.
www.rzimacademy.org