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The following information needs to be filled out completely to be considered for the Shackelford Scholarship given to Moffett Memorial Baptist Church members. If approved, you will receive $1000.00 for the fall semester and $1000.00 for the spring semester for the upcoming year. This form is due when you have your information from the college.


Email Address*


City, State, Zip*

Are You...*

School You Will Be Attending*

School Address to Mail Scholarship Check*

Address 2

City, State, Zip*

Student Account #*

Thank you for applying for the Shackelford Fund Scholarship. Scholarship Checks will be mailed after July 8th. Please contact the office at 434-793-1722, if you have any questions.

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