Community Education Adult Enrichment Scholarship Application Form
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email Address
Your answer
Home Phone Number
Your answer
Work Phone Number
Your answer
Cell Phone Number
Your answer
What is your total monthly income? (before taxes) Be sure to include any public assistance, child support, alimony, or cash income. *
Your answer
Number of people living in the home? *
Your answer
Is your household currently receiving any form of financial assistance? *
If you are receiving financial assistance, what type? What is the amount?
Your answer
Please provide any additional information you may have supporting your need for financial assistance.
Your answer
What is the program or class title for which you would like to register? *
Your answer
What is the fee for the program or class in which you are interested? *
Your answer
Funds for scholarships are limited. As a result, we must have a commitment on the part of participants to attend the programs or classes for which they have registered. Scholarship funds will be forfeited if you transfer, cancel or are absent from the program or class. *
By typing your name below, you are certifying that all information provided in this form is true and accurate. Income verification may be required. *
Your answer
Thank you for your interest in Wayzata Community Education. You will be contacted within 7-10 business days regarding the status of your application.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Wayzata Public Schools. Report Abuse - Terms of Service
Google Forms