Alicias Blessings Scholarship Form
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
How did you hear about us?
*
Please Select
Newspaper
Internet
Magazine
Other
Please Specify
*
Name/ Birthdays/ Age of each child being sponsored:
What does your children enjoy? (Example: toys, pools, candys, color, any activity.)
Give us a story that describes your child. (ex, adventurous... explain) For each child.
Do your children have any nicknames they go by?
Do you already have a swim instructor? Please provide there name.
Have you ever received a scholarship from Alicias Blessings? If so, please explane.
How did you hear about Alicias Blessings?
Please prove a 1-2 paragraph explaining how this scholarship will impact your family and what it will mean for your family if you get it.
Signature
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