Scholarship Request
Please fill out this form and click submit.
Students Name
*
Parent/Guardian Full Name(s)
*
Student Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Dad Cell #
*
Mom Cell #
*
Email
*
This address will receive a confirmation email
Which event are you requesting scholarship for?
*
Family Contribution $
*
Scholarship Requested $
*
Has the student received a scholarship in the past?
*
Please select one option.
Yes
No
Select Option
Yes
No
If yes, when?
Do you need budgeting help?
*
Please select one option.
Yes
No
Select Option
Yes
No
Do you have a budget or plan in place to pay full fees for your child in the future?
*
Does your child regularly attend New Life Church?
*
Please select one option.
Yes
No
Select Option
Yes
No
Do you regularly attend New LIfe Church?
*
Please select one option.
Yes
No
Select Option
Yes
No
I understand that completing this request does not guarentee a scholarship.
*
Please select one option.
Yes
Sign First and Last Name
*
Submit
Description
Please fill out this form and click submit.
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