Retreat/Trip/Event Scholarship — Living Stones Christian Church

Retreat, Trip or Event Scholarship REQUEST

ATTENTION! THIS FORM IS ONLY FOR SCHOLARSHIP REQUESTS!

Please don’t let cost be factor in attending an LSCC sponsored Retreat, Trip or Event. Scholarships are available for those with financial need. Fill out this short form to apply. If you have any questions, contact Peggy Koralage.

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Total Event Cost

Total Scholarship Requested (Subsidy amount)

Fund Request Category

Dates of Event if applicable

Comments

By typing my name below and submitting this form, I certify that I am the individual represented above, and that I agree to the above.