SCHOLARSHIP APPLICATION
The Jackson Hole Leadership Program provides scholarship opportunities for children who are in need and qualify financially. To be eligible for a full or partial scholarship, please complete the following information sheet. All information will remain confidential.
Child's Name
Your answer
Parent(s) Name(s)
Your answer
Mailing Address
Your answer
Email Address(s)
Your answer
Best Contact Phone Number
Your answer
Alternative Phone #
Your answer
JHLP Program (select one)
Cost of Program
Your answer
Total Funds Requested
Your answer
Provide a brief explanation of your reason for requesting assistance:
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Organizational Referral
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Organizational Contact Name
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Referral Contact Phone #
Your answer
I certify that all of the information submitted in this form is true
Required
Name of Person Completing Form
Your answer
Submit
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