BIPOC Scholarship Application

BIPOC Scholarship Application - STUDENT

This Scholarship is for people who identify as BIPOC (Black, Indigenous, and People of Color)
I understand this scholarship is offered to applicants who identify as Black, Indigenous, and People of Color.
Applicant's Name*

First NameLast Name
Parent's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Alternative Phone Number
Class/Program Your Child is Interested in Attending*
Date/Semester*
Please select the scholarship you would like to apply for.
Tell us about your child, your family’s background, and the dreams you have for your child.*
Describe your child’s current relationship with the natural world and why you are interested in this program for them. What are you hoping they learn?*
*Scholarship applications will be reviewed and offers will be made once the minimum number of registered participants has been met*

Please note that in order to make scholarships available to the greatest number of families, we have implemented the following limitations. Each student may receive scholarships for one of the following:
- One semester-long program per school year
- Up to 5 single day programs per calendar year
- One week of summer camp per year
Applicants may reapply one calendar year after their last application date. In order to share this opportunity with as many people as possible, priority will be given to first time scholarship applicants.

Note: Submission of a scholarship application does NOT automatically register a participant for a class/program or reserve a space in that class/program. In order to register, please call our office at 949-709-5777 or email info@earthrootsfieldschool.org. Please do not register online for a class/program if you are applying for a scholarship for that class/program.

I certify that the above information is accurate to the best of my knowledge.
Signature of Applicant or Parent/Legal Guardian, if applicant is a minor*

Clear
Today's Date*

MonthDayYear
Date
The number of scholarships awarded, will be determined by donations provided and the number of applications received. If there are more BIPOC Scholarship applicants than there are spaces available, recipient names will be added to a lottery and drawn at random. In the event that you are not selected for the BIPOC Scholarship, and if you would like to be considered for a Needs Based Scholarship, please also fill out a separate Needs Based Scholarship Application.

Earthroots Field School PO Box 504, Trabuco Canyon, CA 92678 info@earthrootsfieldschool.org

Earthroots Field School does not discriminate on the basis of race, color, religion, age, sex, disability, ethnic origin, or sexual orientation.
Earthroots Field School | PO Box 504, Trabuco Canyon, CA 92678 | 949-709-5777
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BIPOC Scholarship Application - STUDENT