Discovery Weekend Scholarship Application

Discovery Weekend Scholarship Application
Name*

First NameLast Name
Email*
example@example.com
Spouse's Name (if applicable)

First NameLast Name
Names and ages of children living at home (if applicable)
Annual Household Income*
Please share the circumstances surrounding your request for financial assistance for the Discovery Weekend.*
Financial Assistance Policies:
- Financial assistance is awarded based on need and availability of scholarship funds
- The maximum amount of financial assistance given to each applicant will be up to 75% of the candidate portion of the Discovery Weekend
- Requests for financial assistance will be reviewed by the Chicago Central District Board of Ministry Executive Committee
I have read and understand the financial assistance policies listed above. I certify the above information is true and complete to the best of my knowledge, and that I do not have additional income not represented above. I agree, if necessary, to send additional information and documentation to support the above statements. I understand that financial assistance is based on need. I understand that falsifying any of the above information could jeopardize financial assistance now and/or in the future.*

Clear
Applicant Signature
Should be Empty: