El Espejo Scholarship Application

Student name: *

Student Information

Parents / Guardians name: *

Phone number: *

Needs Assessment

Will you need a full scholarship, or a partial scholarship? *

Full Scholarship

Partial Scholarship

We can pay $

Will you need a full scholarship, or a partial scholarship? We can pay $

Short Essays

Please explain any circumstance that is keeping you from being able to pay for the program. *

How would this experience benefit you in achieving your personal goals? *

Agreement

If you have any questions or need help filling out this form please contact

Poudre Learning Center
8313 West F Street
Greeley, Colorado 80631
Or email to: trusch@plcoutdoors.org

By submitting this form electronically you certify that all information supplied in this application is accurate and complete.

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