Application for Loan from

The James H. and Mary M. Gnam Educational Trust

Borrower's Personal Information:

Borrowers Name: _______________________________________

Address: _____________________________________________

City:_____________________________ State:______ Zip Code: ___________________

Social Security Number: _________________________

Date of Birth: _______________________

Place of Birth: ____________________________________________________________

Employer (if applicable): _____________________________________________________

Address: ________________________________________________________________

City:_____________________________ State:_______ Zip Code: __________________

Highest Level of Education You Currently Have Completed:

High School ________ Associates Degree ________ Bachelors Degree ____________

Post Graduate Degree, specify: ______________________________________________ ______________________________________________________________________

Vocational or Technical Certificate, specify: _____________________________________ ______________________________________________________________________

Address of Institution: _____________________________________________________

City: ___________________________ State: _________ Zip Code: _______________

GUARANTOR/CO-APPLICANT INFORMATION:

Parent(s) Name: _______________________________________________________

Address: _____________________________________________________________

City:_____________________________ State:_______ Zip Code: __________________

Employer (if applicable): _____________________________________________________

Address: ________________________________________________________________

City:_____________________________ State:_______ Zip Code: __________________

Parent(s) Name: _________________________________________________________

Address: _______________________________________________________________

City:_____________________________ State:_______ Zip Code: __________________

Employer (if applicable): _____________________________________________________

Address: ________________________________________________________________

City:_____________________________ State:_______ Zip Code: __________________

School Information:

Name: __________________________________________________________________

Address: ________________________________________________________________

City:_____________________________ State:_______________ Zip Code: __________

When did you start attending this institution (or when do you expect to start attending this institution): ________________________________________________________________________

What degree do you intend to pursue during this course of study: ____________________

Vocational or Technical Certificate, specify: ____________________________________

Associates Degree ___ Bachelors Degree ____

Post Grad. Degree, specify: __________________________________________________

When do you anticipate completing this degree: ____________________________________

Completed Application for Federal Student Aid. Please enclose.

Other Information:

Have you ever filed a petition in bankruptcy or otherwise sought judicial relief from your debts? Yes No If yes, please state the date, case number, court and federal judicial district.

________________________________________________________________________

Have you ever been convicted of a felony, or a larceny offense? Yes No

If yes, please state the date of the conviction, court, felony charged, felony convicted and the case number.

________________________________________________________________________

Are you currently a defendant in any legal action? Yes No If yes, please provide the case number, court filed in, date filed in, anticipated date of trial, nature of the case, and, if possible, your financial exposure in the matter. _______________________________________________________________________

_______________________________________________________________________

Are you obligated to pay any spousal or child support to another person? Yes No If so, please provide the number of children, their ages, how much you are obligated to pay, any arrears in payments, the name of the court that Ordered the payments, and the case number.

________________________________________________________________________

Do you have any contingent liabilities as an endorser or guarantor of the debts of another? Yes No (If yes, please attached a schedule of such debts).

________________________________________________________________________

Have you or your proposed guarantor/co-applicant ever defaulted on repayment of a student loan or other educational obligation? Yes No (If yes, please attached a statement containing the details of such transaction, including the current status of such obligation). ________________________________________________________________________

________________________________________________________________________

Date: ______________

Borrower: _____________________________

Guarantor/Co-Applicant: _____________________________

STATE OF ______________

COUNTY/CITY OF _____________________

I, _____________________________, a notary public in and for the aforesaid jurisdiction did witness _______________________, the borrower, sign this Application for The James H. and Mary M. Gnam Educational Trust on this the _____ day of ___________, 200_.

_______________________________

Notary Public

My Commission Expires:

STATE OF ______________

COUNTY/CITY OF _____________________

I, _____________________________, a notary public in and for the aforesaid jurisdiction did witness _______________________, the guarantor/co-applicant, sign this Application for The James H. and Mary M. Gnam Educational Trust on this the _____ day of ___________, 200_.

_______________________________

Notary Public

My Commission Expires:

STATE OF ______________

COUNTY/CITY OF _____________________

_______________________________

Notary Public

My Commission Expires:

Attachments: Pursuant to Rule 3.1 of the Rules of the James H. and Mary M. Gnam Educational Trust, please attach the following documents. Your application will not be processed without all of these documents.

1. A birth certificate or certificates, or other evidence of live birth, evidencing the relationship of the borrower to James McConlogue or Alois Gnam. (Unless the Trustee is already in possession of such documents and has waived this requirement, in whole or in part.)

2. A current credit report issued by a recognized national or regional consumer credit reporting agency.

3. A copy of the letter of acceptance or such document evidencing the enrollment of the proposed beneficiary in the university, college or school for which this loan application is made.

4. Evidence of substantial efforts of the proposed beneficiary to obtain funding, scholarships, educational loans or assistance from sources other than the Trust.

5. Proof of full-time employment in the case of a part-time student that has obtained a waiver from the Trustee.

6. Tax returns for the two (2) calendar years immediately preceding the semester for which any loan is sought for the borrower and each guarantor/co-applicant. If the proposed beneficiary is or has been claimed as a dependent on any person’s tax return in such years, then copies of those returns must be provided as well.

7. High school, college or current academic transcript. For beneficiaries still attending school, transcripts or certified grades are required at the conclusion of each academic reporting period. No loan or additional funding will be provided without certified transcripts or grades following each academic period.

8. Completed Application for Federal Student Aid.

9. Copy of the Rules and Regulations of the James H. and Mary M. Gnam Educational Trust Fund signed and notarized by the beneficiary and every guarantor.

10. Thirty Dollar ($30.00) processing fee.