Family Ministry Scholarship Application
Completing an application does not guarantee assistance. A staff member will follow up with you once your application has been processed.
Campus
*
Cedar Falls
Decorah
Fort Dodge
Grinnell
Independence
New Hampton
Osage
Name of Event
*
Parent Name
*
First Name
Last Name
Parent Cell Phone
*
-
Area Code
Phone Number
Parent Email
*
example@example.com
Student Name
*
First Name
Last Name
Student Date of Birth
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Reason For Applying
*
How much are you able to put toward this event?
*
[Dollar Amount]
Submit
Should be Empty: