Youth - Scholarship Form (English) - updated

*First Name

*Last Name

*Email Address

*Phone Number

*Address Line 1

Address Line 2

*City

*State/Province/Region

*Zip/Postal Code

Please complete this form to apply for a scholarship for any MDPC Youth event.
*One application per child.
*One application per event.

If you have any questions, please contact Megan Hulings at mhulings@mdpc.org.

*Applying for a scholarship for what MDPC Youth event:

*Event Date:

*Who is completing this application:

*Congregation:

*Total Cost of Event:

*Participant's First Name:

*Participant's Last Name:

*Participant's Date of Birth:

*Participant's Cell Phone:

*Participant's Email Address:

*Parent/Guardian First Name:

*Parent/Guardian Last Name:

Parent/Guardian Date of Birth:

*Parent/Guardian Cell Phone:

*Parent/Guardian Email Address:

*Scholarship Options (please choose one):

30% Scholarship (You pay 70% of the total cost of the event)50% Scholarship (You pay 50% of the total cost of the event)80% Scholarship (You pay 20% of the total cost of the event)100% Scholarship (You pay none of the total cost of the event)

*Why do you believe it is important for your youth to attend this event:

*Please describe the situation that causes your need at this time:

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