Leadership Lafayette - Tuition Assistance Request
Name
*
First Name
Last Name
Email
*
example@example.com
Please indicate the income range that best represents your household's annual income. (Lafayette, LA median income ~$63,000)
*
Below Median Range
Around Median Range
Above Median Range
Prefer Not to Disclose
Are there any difficulties you are facing that could impact your ability to afford tuition?
*
0/100
In comparison to other expenses, how does the cost of the program fit into your overall budget? Do any of these expenses affect your ability to fully participate in the program?
*
0/100
Employer
*
Employment Type
*
Private Business Employee
Owner/Operator of Small Business
Government/Public Organization Employee
Nonprofit Organization Employee
Other
Have you approached your employer concerning their financial support?
*
Yes
No
Employer Contribution
*
Type an amount
Additional Contributions from associations, community organizations, and/or civic organizations
*
Type an amount
What funding options have you explored, if any?
*
Employer support
Crowdfunding
Interest-Free Loan through our partner, Advancial
Other forms of sponsorships
Other
Are you planning on exploring any of the options listed above? If so, which one(s)? If not, can you please share what may be holding you back?
*
Total amount of tuition assistance being requested
*
Please Select
$1,000
$750
$500
$250
Will you be able to participate in the program if you are not awarded tuition assistance?
*
Yes
No
Save
Submit
Should be Empty: