ExplorationWorks Fall 2019 After School Scholarship Application
The ExplorationWorks scholarship fund ensures that all families have the chance to experience ExplorationWorks' interactive and fun-filled science education programming. There are a limited number of scholarships available. Please make your request and wait for a response from the scholarship committee before signing your student up for class. No refunds will be given for the cost of a class if you have already paid for the class and receive a scholarship. Please submit a form for each child.
Student First Name *
Your answer
Student Last Name *
Your answer
Student Age *
Your answer
School that your student attends *
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian Phone Number (Please include area code) *
Your answer
After School Class for which funds are requested: *
Your answer
Please check the scholarship amount you are requesting (Note: Percentages are of the member price) *
Required
Do you qualify for any of the following assistance programs? Please check all that apply. *
Required
If you do not qualify for any of the above assistance programs, please describe your financial need:
Your answer
Please describe how you hope your student will be impacted by participating in an ExplorationWorks program: *
Your answer
Would you be willing to be contacted to provide a testimonial about the impact of our scholarship fund? *
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