Scholarship Request
Please fill out this form and click submit.
Personal
Name
*
If person requesting scholarship is a minor, please include an adult contact.
Address
*
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AA
AB
AE
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AL
AP
AR
AS
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BC
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DC
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MH
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NB
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WA
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YT
Phone
*
Email
*
Request Details
How long have you attended Ekklesia?
*
What event are you requesting a scholarship for?
*
How much are you / your family able to contribute toward the cost of the event?
*
Are there any other circumstances you would like for us to understand in processing your scholarship request?
*
Electronic Signature
*
Date
*
Submit
Description
Please fill out this form and click submit.
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