Scholarship Form for Church Members
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Name *
First and last name
Email *
Phone number *
Which scholarship(s) are you interested in? *
What year did you join 1st Congregational church? *
List, in detail, the ways you have substantially participated in life at First Congregational UCC, Dubuque, IA,  since you became a member
Reflect on how your membership at First Congregational UCC, Dubuque, IA, has impacted your life
Please share briefly what this scholarship will mean to you in your faith journey.
Conference Name or Camp Name
What is the total program cost?
Have you received any scholarships from our church in the past? *
List past scholarships below
I certify, to the best of my knowledge, that the information contained in this application is correct and complete. *
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