Apply for a scholarship Parent/Guardian Name * First Name Last Name Child Name First Name Last Name Age * 11 12 13 14 15 16 17 Parent Phone Number * (###) ### #### Parent Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Which program are you interested in receiving a scholarship for? * What amount are you comfortable paying? * Why do you think your child would benefit from this program? * Does your child have reliable transportation to and from activities? * Does your child need any gear or clothing outside of what is already provided? * Are you 100% committed to your child attending the program or event you are signing up for? * If you receive a scholarship and you do not show up for the program, you will not be able to apply for a scholarship in the future. Yes No Thank you for applying for a scholarship. We will be in touch shortly. If you have any questions, please reach out to ashley@girlandherbackpack.com
