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Learning Scholarship Request
Your name and contact information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Phone
*
Newsletter
Please add me to the W2W Kentuckiana mailing list
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Scholarship request information
Name of class, event, or request
*
Who offers this?
Please select the organization that is offering the event you are requesting scholarship funds for.
select one
Woman Within Central
Woman Within Colorado
Woman Within Eastern
Woman Within International
Woman Within South Central
Woman Within Western
Spirit of Sophia
MKP
Don't see the organization?
If you don't see the organization hosting the event, please let us know who they are so we can look to consider them in the future.
Please describe this event in a few words
Has this event been identified as an event approved for a Learning Scholarship?
*
Yes
No
Not sure
Full cost of event
*
Scholarship amount requested
*
Scholarship funds are limited to $300/year, with a maximum of 75% covered for any single event.
Special Request to Send Payment
If approved, scholarship funds will be sent via check to your address above. If you prefer to have payment sent directly to the event provider, please include their full name and mailing address here.
Event Information
Please provide us with any contact information you may have for this event.
Event Date
(mm/dd/yyyy)
Event website
Event email
Verify Email
Event phone
Event contact person
Prefix
First Name
Last Name
Suffix