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Financial Aid Application

Please complete the form below to be considered for financial aid. If you have any questions regarding the information requested on the form please email This e-mail address is being protected from spambots. You need JavaScript enabled to view it or call 1-800-670-ELIM. You may also download the form here and mail it to Elim Bible Institute, ATTN: Enrollment Services, 7245 College St. Lima, NY 14485.

Applicant Information

First name

Middle name

Last name

E-mail address

Date of birth

Financial aid requested for

I am a

Church Information

Church name

Senior pastor name

Parents' Financial Information

I am financially independent (If selected, skip this section).

What was your parent's adjusted gross income for 2009?

Your parents' number of family members in 2010-2011?

Number of people in your parents' household who will be college students in 2010-2011?

As of today, what is your parents' total balance of cash, savings, and checking accounts?

Applicant's Financial Information

What was your adjusted gross income for 2009?

Your number of family members in 2010-2011?

Number of people in your household who will be college students in 2010-2011?

As of today, what is your total balance of cash, savings, and checking accounts?

To be answered by the applicant

Select all that apply:

I am a child of an Elim Fellowship minister
I am a child of an Elim Fellowship missionary
I am a child of an Elim Bible Institute alumnus

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