Program Scholarship Application

Program Scholarship Application
Friends of Ambler Farm is a 501(c)3 non-profit organization. We make every effort to make our programs accessible to the entire community. Program Scholarships are given out based on financial need and distributed on a case by case basis, dependent on fund availability. Full or partial scholarships may be awarded. Payment plans may be available to handle balance due after partial scholarships or if a scholarship is not available. Please note that we cannot provide any transportation to or from the farm. To be considered for a Program scholarship, please complete the application below.
Child's Name*
Program or Field Trip Name for which you are requesting scholarship funding*
Date of Birth

MonthDayYear
Date
Grade your child will be entering in the Fall
Parent/Guardian's Name
Address
CityStateZip
Email
example@example.com
Home
Cell
Please indicate your Total Household Annual Income
Level of assistance requested FullPartialPayment Plan Please be aware that scholarship funds are limited
Summer Program Scholarship Application, Page 2
PERSONAL STATEMENT
Are there any other extenuating circumstances that we should be aware of
*BY SIGNING THIS APPLICATION, I AM VERIFYING THAT ALL INFORMATION CONTAINED HEREIN IS FACTUALLY CORRECT AND HONESTLY PRESENTED BY ME, THE PARENT/GUARDIAN
Signature of ParentGuardian

Clear
Date

MonthDayYear
Date
Completed applications should be emailed to Kevin Meehan, Program Director at kevin@amblerfarm.org.
Should be Empty:

PERSONAL STATEMENT