Scholar House Interest Form
First & Last Name
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Best timeframe for us to call you?
*
Morning 8:00-12:00 p.m.
Afternoon 12:00-4:00 p.m.
Evening 4:00-8:00
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Choose a Scholar House Campus
*
Anderson
Muncie (Coming soon)
Marion (Coming soon)
Scholar House housing is available to single parents while they are in school. Parents with full custody of their non-adult dependents are eligible. Are you interested in housing?
*
Yes
No
How many non-adult dependents reside with you?
*
Education Level Completed
*
High School Diploma
High School Equivalency
Associate Degree
Bachelor's Degree
Are you currently enrolled in a school or apprenticeship program?
*
Yes
No
How did you hear about us?
*
Facebook
Internet Search
JobSource Website
Current Scholar
Flyer
Other
Submit
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