Scholarship Application

Scholarships Application

Funds have been set aside to be used specifically for program scholarships. While the Highlands Center does not grant full scholarships, we do supply partial for those in financial need. Scholarships are limited to two per child per year.

"*" indicates required fields

Name of Recipient*

First Last

Age of Recipient*

Name of Parent/Guardian*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

Are you a member?*

Yes

What program is being applied for?*

What amount are you able to pay?*

Please note we only award partial scholarships.

In the space below, please write 2-3 paragraphs about the following points:*

Please briefly describe your financial situation. What qualifies you to be a scholarship recipient?

Would you like to add another child to this application?*
Yes
No

Name of Recipient
First Last

Age of Recipient

What program is being applied for?

What amount are you able to pay?
Please note we only award partial scholarships.

Would you like to add a third child to this application?
Yes
No

Name of Recipient
First Last

Age of Recipient

What program is being applied for?

What amount are you able to pay?
Please note we only award partial scholarships.

Scholarships Application

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