Rooted Scholarship Application Form

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Thanks so much for your interest in Rooted! We believe that Rooted is a life-changing experience and we want everyone to participate! We understand that the Rooted registration fee may be a burden for some and we are happy to support you if that is your current situation. To be considered for assistance please fill out the following information.

First & Last Name *

Address

Phone Number *

Email Address *

Date of Birth *

YYYY

Which campus do you attend? *

Mesa

Gilbert

Queen Creek

Glendale

Ahwatukee

Tempe

Online

I do not attend Central

Are you employed? *

Yes

Other:

If yes, for how long and where?

Spouse's Name (or significant other living with you)

Monthly household income:

Monthly household expenses

Please briefly explain the reason for seeking assistance at this time: *

Submit

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