Scholarship Evaluator Application

Scholarship Evaluator Application
We thank you for your interest in the selection process for the Community Scholarship Program at the LaGrange County Community Foundation. To register as a volunteer evaluator, please complete the form below.
Name*

First NameLast Name
Email*
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
What is your date of birth?*

MonthDayYear
Date
Occupation*
Employer*
Should be Empty: