Lighthouse Scholarship Request Form
Name
*
First Name
Last Name
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Please describe your relationship to Lighthouse
*
Member
Regular Attender
Other
What event are you requesting a scholarship for?
*
Please Select
Youth and College Retreat
If your event is not listed above, please enter event name here:
What is the full registration cost for this event?
*
How much of the registration cost are you able to pay?
*
Please describe the reason for your scholarship request.
*
Please describe how you think this event will benefit you.
*
Name and e-mail of ministry leader for reference
Submit
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