About You:First Name *Middle Name *Last Name *Street Address *City *State/Province *ZIP / Postal Code *Email Address *Mobile Phone *Home PhoneBirthdate *MonthSelect month123456789101112DaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year2020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990Last 4 Digits - Social Security Number *High School You are Graduating/Graduated From *Lincoln CharterEast Lincoln High SchoolLincolnton High SchoolNorth Lincoln High SchoolWest Lincoln High SchoolGraduating Year *College you attend / plan to attendEstimated Graduating Year *Upload Latest High School or College TranscriptChoose FileNo file chosenDelete uploaded fileAcceptance Letter if first year attending collegeChoose FileNo file chosenDelete uploaded fileIf approved, will this be your first Rotary Student Loan? *YESNOcheck yes or noParent / Guardian Info:Father's Full Name *Street Address *City *State/Province *ZIP / Postal Code *Email Address *Mobile Phone *Home PhoneFather's Last 4 Digits - Social Security Number *Father's OccupationFather's EmployerYears EmployedMother's Full Name *Street Address *City *State/Province *ZIP / Postal Code *Email Address *Mobile Phone *Home PhoneMother's Last 4 Digits - Social Security NumberMother's OccupationMother's EmployerYears EmployedPersonal ReferencesList 3 Personal References with email address and phone numberFinancial ArrangementsEstimated TuitionEstimated Room/BoardEstimated Books/Fees/OtherTotal Annual CostsTotal Amount You Are Applying For(up to $4000 - annual amount varies)Applicants Consent *Yes, I agree to the full responsibility of this loan if provided, and I consent that all information provided is honest and correct to the best of my knowledge.Co-Borrowers InformationThree BORROWERs are required per loan - Student, and 2 additional borrowersCo-Borrower 1Street AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeEmail AddressPreferred Phone NumberBirthdate *MonthSelect month123456789101112DaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year2020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Last 4 Digits - Social Security NumberEmployers NameOccupationYears EmployedGross Income/MonthDo You Own or Rent Your Home?Monthly Mortgage/Rental PaymentName of BankTypes of Account(s)Co-Borrower 1 Credit ReferencesPlease list 3 credit institutions complete with Name, Address, Phone, Account Number(s) and BalanceCredit Reference 1Credit Reference 2Credit Reference 3Co-Borrower 1 Consent *Yes, I agree to serve as a Co-Borrower to this loan if provided, and I consent that all information provided is honest and correct to the best of my knowledge.Co-Borrower 2Street AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeEmail AddressPreferred Phone NumberBirthdate *MonthSelect month123456789101112DaySelect day12345678910111213141516171819202122232425262728293031YearSelect Year2020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Last 4 Digits - Social Security NumberEmployers NameOccupationYears EmployedGross Income/MonthDo You Own or Rent Your Home?Monthly Mortgage/Rental PaymentName of BankTypes of Account(s)Co-Borrower 2 Credit ReferencesPlease list 3 credit institutions complete with Name, Address, Phone, Account Number(s) and BalanceCredit Reference 1Credit Reference 2Credit Reference 3Co-Borrower 2 Consent *Yes, I agree to serve as a Co-Borrower to this loan if provided, and I consent that all information provided is honest and correct to the best of my knowledge.Send Message
