Scholarship Application
The Archdiocese of Kansas City in Kansas has funds available for those facing challenges in providing necessary costs for a retreat, mission trip, camp, or youth event. If you would like to apply for a scholarship, please complete this form. Have questions before applying? Contact Rick at 913.647.0351
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Youth Name (who the scholarship is for) *
Date of Birth *
MM
/
DD
/
YYYY
Age at time of event? *
Parent Guardian Name *
Primary Contact Number *
Address: City/State/Zip *
Parent/Guardian Email *
Household Income *
Number of Family Members *
Youth Event Requesting Help For? *
Parish *
Required
Parish Contribution? *
Family Contribution *
Scholarship Amount Requested *
Pastor/DRE/YM Name *
Briefly describe your situation, and your involvement in your parish. Have you attended this camp/event before? Why are you interested in attending this event? *
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