Community Education Enrichment Scholarship Application Form For Youth
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Birth Date *
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DD
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YYYY
Street Address *
Your answer
City *
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State *
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Zip Code *
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What school does the child attend? *
Your answer
What grade will your child complete this school year? *
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Parent's Name
Your answer
Parent Email Address
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Parent Home Phone Number
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Parent Work Phone Number
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Parent Cell Phone Number
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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.
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