The Effective Leadership Academy Scholarship Application
Thank you for expressing an interest in participating in ELA programming.

ORGANIZATION MISSION: To help young people develop their most valuable asset – themselves.

ORGANIZATION VISION: To ensure that all eligible students have equal access to ELA’s educational programs.

FEDERAL TAX ID: 26-3385437

ADDRESS: 4480 Richmond Road, Warrensville Heights, OH 44128

WEB ADDRESS: www.effectivela.org

ELA offers a partial scholarship opportunity to students with a keen interest in personal leadership development that may not be able to afford registration fees. Applicants must qualify for the National School Lunch Program/School Financial Aid and be entering grades 5-12.

These scholarships are provided through gifts from various businesses, foundations and individuals that believe in supporting ELA programming and providing our young people with essential 21st Century Skills.

APPLICATIONS ARE DUE WITHIN 5 DAYS OF PROGRAM REGISTRATION; PAYMENT DUE WITHIN 10 DAYS OF ACCEPTANCE TO HOLD PLACE IN PROGRAM UNLESS CONTACTED FOR SPECIAL CIRCUMSTANCES.

Student Name *
Your answer
Grade Level for 2018-19 *
Your answer
Parent/Guardian Name *
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email Address
Your answer
Preferred method of contact *
Required
Student School & School District *
Your answer
Program Type *
Preferred Program Location Site *
Your answer
*For Ahuja Medical Center Campers only* If N/A, skip to student response. Are you, or a member of your immediate family, a University Hospitals- Ahuja Medical Center employee?
If indicated 'other connection to UH- Ahuja' above, please describe here. Otherwise, skip to next question!
Your answer
Student Response--Describe what has led you to want to participate in an ELA program. *
Students should respond to each question in a few sentences to the best of their ability.
Your answer
Student Response--What skills do you hope to learn from this leadership experience? *
Your answer
Student Response-- How do you plan to use your leadership experience after the program is over?
Your answer
Financial Need (Parent/Guardian section)- Check the option(s) that apply to you *
In order to impact the most children we can, we are very prudent in our use of funds, please complete the following questions to help us, help you.
Required
Our current annual family income is: *
Your answer
If there are any extenuating circumstances, you wish to share with our committee to help us make our decision, please share them here.
Your answer
All recipients will need to pay a nominal registration fee based upon need. Please state your program below, followed by "I feel I can contribute $___" with the amount you feel you can pay. *
Original costs: Club Lead $215; Transitions $250; Camp Lead $295; Chamber Lead $195
Your answer
Please digitally sign your name to indicate that the above information is a true indication of your current financial situation. *
The Scholarship Committee strives hard to allocate our scholarship funds to as many deserving candidates as possible. After reviewing your application, the Scholarship Committee will inform you of the result. Scholarships are awarded of varying degrees.
Your answer
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