Missions Scholarship Application - Covington Baptist Association

This field is for validation purposes and should be left unchanged.

Church Name(Required)

Church Address(Required)

Street Address Address Line 2 City State ZIP Code

What type of mission trip are you going on?(Required)

What agency?(Required)

What is your trip destination?(Required)

Team Leader's Name(Required)

First Last

Team Leader's Phone Number(Required)

Team Leader's Email(Required)

Please list all team members and the funds needed for each individual:(Required)

Total Funds Requested:(Required)

Date Funds are Needed:(Required)

Agreement:(Required)

By checking this box, I certify that the persons listed above have been selected to represent our church in the above mission endeavor and I further request that the Covington Baptist Association grant scholarships in the amount listed above.

Digital Signature(Required)

Please type your full legal name. By doing so, you agree that this electronic signature is the legally binding equivalent of your handwritten signature.

Today's Date(Required)