Scholarship Application

Single Parent - Scholarship Assistance Application

• • Event Information*
    Enter the name of the event you have registered to attend.
  • Reservation number:*
    **Please Note: A reservation number is required for applications to be reviewed.
  • What is the first date of the event you are registered for?**
    MM

    DD

    YYYY
  • Are you a member of a group attending a Sandy Cove Programming Event?**
    
    
    Yes

    No
  • Specify the name of the group:*
  • Your Information*
    First Name

    Last Name
  • Your Email*
     
  • Phone Number*
     

    (###)

    -

    ###

    -

    ####
  • Please enter your full address below:*
    Street Address*

    Address Line 2

    City*

    Province / State / Region*

    Postal Code / Zip

    Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

    Country*
• • What is your marital status?*
    >Please SelectSingleMarriedWidowedDivorcedSeparated
• Your Children's Information
  • Number of children living in your home including children attending college: (Please include others living in your home in the Optional Notes box at the bottom of the form.)*
    >Please Select0123456789101112
  • Child 1 Name*
    First Name

    Last Name
  • Child 1 Birthdate*
    MM

    DD

    YYYY
  • Child 2 Name*
    First Name

    Last Name
  • Child 2 Birthdate*
    MM

    DD

    YYYY
  • Child 3 Name*
    First Name

    Last Name
  • Child 3 Birthdate*
    MM

    DD

    YYYY
  • Child 4 Name*
    First Name

    Last Name
  • Child 4 Birthdate*
    MM

    DD

    YYYY
  • Child 5 Name*
    First Name

    Last Name
  • Child 5 Birthdate*
    MM

    DD

    YYYY
  • Child 6 Name*
    First Name

    Last Name
  • Child 6 Birthdate*
    MM

    DD

    YYYY
  • Child 7 Name*
    First Name

    Last Name
  • Child 7 Birthdate*
    MM

    DD

    YYYY
  • Child 8 Name*
    First Name

    Last Name
  • Child 8 Birthdate*
    MM

    DD

    YYYY
  • Child 9 Name*
    First Name

    Last Name
  • Child 9 Birthdate*
    MM

    DD

    YYYY
  • Child 10 Name*
    First Name

    Last Name
  • Child 10 Birthdate*
    MM

    DD

    YYYY
  • Child 11 Name*
    First Name

    Last Name
  • Child 11 Birthdate*
    MM

    DD

    YYYY
  • Child 12 Name*
    First Name

    Last Name
  • Child 12 Birthdate*
    MM

    DD

    YYYY
• Financial Information
  • Have you been to Sandy Cove before?*
    Yes

    No
  • Have you or anyone on this application received a scholarship from Sandy Cove in the last five years?*
    Yes

    No
  • Full cost of the event you wish to attend:*
    $

    Dollars

    Cent
  • What is the maximum amount you are able to contribute?*
    $

    Dollars

    Cent
  • Applicant's Monthly Income*
    Please include all income sources.
    $

    Dollars

    Cent
  • Current Household Monthly Income*
    Please include all income sources.
    $

    Dollars

    Cent
  • If assistance is denied, please cancel my reservation and refund my deposit:*
    Yes

    No
  • Your Occupation*
  • Please explain the SPECIFIC FINANCIAL REASONS prompting you to apply for scholarship assistance.*
    (such as loss of employment, loss of income, unexpected medical bills, change in family status, etc.)
• Confirmation

  Check the box and choose submission date to "sign" your application, indicating that the information you entered is true and complete, to the best of your knowledge. It is our desire to be accountable to the Lord and to be good stewards of the resources He has entrusted to us. We ask you to prayerfully complete this application, stating that you have a financial hardship which would prevent you from attending Sandy Cove without financial assistance.
  • I certify that the information provided on this application is true and accurate.*
    Yes
  • Today's Date*
    MM

    DD

    YYYY
  • I give consent to use this information to send additional emails and communication as described in our Privacy Policy.*
    Yes

    No
• 
  Submit