Request for Scholarship
This is the official Indian River County 4-H Foundation Scholarship Request Form. The IRC 4-H Foundation is dedicated to promoting, supporting, and funding our 4-H Community! Please submit this form at least 2 weeks prior to the event registration deadline. The submission of this form DOES NOT guarantee funds. An email with an official decision will be sent to the requester and leader after the IRC 4-H Foundation Board has an opportunity to review the request. Please contact IRC4HFoundation@gmail.com with any questions.
Name of 4-H Event
Your answer
Name of 4-H Participant(s)
Your answer
Number of Participants
Your answer
Member of What IRC 4-H Club?
Your answer
Description of Event
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Total Cost of Event
Your answer
Total Amount Requested
Your answer
Requested By
Your answer
Relationship to 4-H Participant
Your answer
Mailing Address
Your answer
Phone Number
Your answer
Email Address
Your answer
Club Leader Name
Your answer
Club Leader Phone Number
Your answer
Club Leader Email Address
Your answer
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