Riekes Center Scholarship Application

Riekes Center Scholarship Application

One form per participant, please fill out a separate form for each individual.
Participant Name*

First NameLast Name
Parent/Guardian Name *

First NameLast Name
Parent/Guardian Phone*

Area CodePhone Number
Parent/Guardian Email*
What program are you applying for and what dates?*
How much can you afford to pay for your program?*
How many members in your household including yourself?*
What is your annual household income?*
In a short paragraph, please describe any personal financial circumstances that support your need for financial aid:*
After finishing this form, a financial manager will call you to confirm scholarship amount and answer any other questions.
Should be Empty: