Request edit access
White Pine Programs Scholarship Application
Please FULLY complete this form to be considered for any program scholarship (youth, teen, adult, etc.).

You can choose to register first and pay the program deposit, or apply first - we reserve a select number of spots just for scholarship recipients.

NOTE: If you have ANY problems/questions/etc. with the scholarship application process, please pick up the phone and call us at 207-361-1911. We're happy to help out!

Participant Name (First & Last) *
Your answer
Best Email to Contact: *
Your answer
Parent Name (if applicant under is 18)
Your answer
What Town Do You Live in? *
Your answer
What State Do You Live in? *
Best Phone Number? *
Your answer
What is the Participants Date of Birth? (month/day/year) *
MM
/
DD
/
YYYY
What was the Combined Income of Your Household Last Year? *
How Many People Currently Live in Your Household? *
What type of program are you seeking scholarship support for? *
Next
Never submit passwords through Google Forms.
This form was created inside of White Pine Programs. Report Abuse - Terms of Service