SCHOLARSHIP APPLICATION for SCLC 2023

SCHOLARSHIP APPLICATION

for STUDENT CONSERVATION LEADERS COURSE 2023
Both this application and the Student Conservation Leaders Course application must be received by 11:59 p.m. EST May 31, 2023.

Applicants will be notified of their scholarship status as soon as possible.
Student's Name*

First NameLast Name
Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent or Guardian's Name*

First NameLast Name
Parent/Guardian's Phone Number*

Area CodePhone Number
Parent/Guardian's Email
example@example.com
Scholarship Request:*

50% Scholarship (Program Fee = $75)75% Scholarship (Program Fee = $50)100% Scholarship (Program Fee= $0)
For the household in which the student resides, what is the adjusted gross income? Refer to your 2022 federal tax form 1040 (line 37), 1090 (line 4) or the Ohio tax form 1040 (line 1)*
Number of adults in household:*
Number of children in household:*
Parent/Guardian: Please briefly describe your financial situation, why you are requesting a scholarship, and why your child should be granted this scholarship: *

0/400
You may be asked to submit a recent pay stub or tax return as verification of financial need.

Please direct any questions or concerns to Melinda Voss, Programs Manager at 513-382-9918 or mvoss@ohioriverfdn.org
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