SLCC Scholarship Request Form
Email address *
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
How many children will you be enrolling? *
Your answer
Children's Ages *
List the age of each child that you intend to enroll, separated by a comma
Your answer
Desired Start Date *
MM
/
DD
/
YYYY
What scholarship eligibility criteria do you meet?
(Check all that apply)
Household Size
(only answer if applying for financial need scholarship)
Your answer
Annual Gross Household Income
(only answer if applying for financial need scholarship)
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Questions/Comments?
Your answer
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