THOG 2021 Career & Business Support

Application Date*

Application Type*

Student

Trainee

Small Business PIF Program

Privacy statement
The information you provide in this application is collected for the sole purpose of fulfilling the application requirements RCCG The House of Glory Career and Business Initiative Application for Financial Resources. RCCG The House of Glory Resources Committee will maintain and keep application information private and confidential. Information provided will be used in support of application selection and award.

Part 1 – Applicant Information

First Name*

Last Name*

Date of birth*

×

Telephone number*

Alternate number/contact

Mailing address*

Address line one

Address line two

Years at current residence

Legal status

Citizen

Permanent resident

Email*

Education Background

High school graduate

College/University graduate

Vocational/trade school graduate

Attended some schooling

Degree obtained

(if applicable)

Bachelors (BS)

Masters

Other

Part 2 – Employment Details

Source of income

Employed

Self-employed

Other

Job Position/ title

No. of years working in current occupation

Employment History

(list up to five (5) past and/or current employers and dates employed)

STUDENT APPLICANTS ONLY

Name of High School

Current grade level

Final Semester GPA

Number of honors or AP courses taken

List all College and/or Universities you have received acceptance for

List all scholarships awarded

(if applicable)

Name of College and/or University you will be attending in the Fall

(please attach college admission letter)

Max file size: 25.00 MB. | Allowed file types: pdf | Max number of file: 1

Upload College Admission Letter

Have you declared a major?

Yes

No

If yes, what major?

Write Here

Use the space provided below to tell us about yourself

(goals, achievements, etc…)

Use the space below to express what receiving the Student Award would mean to you…how will $500.00 support your academic endeavors?

Please submit 1 professional letter of recommendation with your application. (For student applicants only)

Max file size: 25.00 MB. | Allowed file types: pdf | Max number of file: 1 | Min number of file: 1

Choose File

CAREER TRAINEE APPLICANTS ONLY

List all certifications obtained

(if any)

Previous professional development endeavors

Any on-the-job training opportunities?

Yes

No

If so, describe below*

Describe in detail the desired training and/or certification you are seeking

Have you attempted this training previously

Yes

No

If yes, explain below*

In the spaces provided below, please describe in detail the reason for career development efforts and/or career changes

In the spaces provided below, tell us about yourself and why you should be a recipient for the Career and Business Initiative grant award of $2,500.00

List 2-3 Professional References

	Name	Relationship	Contact Info
	Name	Relationship	Contact Info
(1).	Name	Relationship	Contact Info
(2).	Name	Relationship	Contact Info
(3).	Name	Relationship	Contact Info

SMALL BUSINESS APPLICANTS ONLY

BUSINESS PIF APPLICATION FORM

Business Type

Micro

Small

Medium

# of Employees

Types of Employees

Application status

New Applicant

Old with O/S Balance

Existing Borrower

Old with Fully Paid Balance

Business information

For Company

Business name

Registration No.

Business telephone#

Office address

Email address

For Single Proprietorship

Name of Registered Owner

Date of Birth

×

Gender

Start of business operation (year)

Products/Services

Describe in detail your business goal and/or business plan;

Describe in detail why your business should be awarded the $5,000.00 PIF Business Award

Describe in detail your strategic financial plans to ensure that you are able to adhere to the repayment requirements…and truly Pay It Forward

List 2-3 Professional References

	Name	Relationship	Contact Info.
	Name	Relationship	Contact Info.
(1)	Name	Relationship	Contact Info.
(2)	Name	Relationship	Contact Info.
(3)	Name	Relationship	Contact Info.

Please submit the follow documents with your application:

Business plan
Credit report from last 3 months’ bank statement
Proof of financial resources to cover other capital expenditures

Max file size: 25.00 MB. | Allowed file types: pdf,docx,doc

Select Files

Form successfully restored