Community Leadership Program 2022 Scholarship Request Form

2021-2022 CLP Scholarship Request Form

The selection committee will review your request for a scholarship along with your application to determine eligibility for a scholarship. Please complete this form and return it by June 30, 2021.

Name

First Name *

Last Name *

Company Name *

Business Address

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Company Phone Number *

Email *

Have you inquired whether or not your employer will pay the tuition? *

Yes No

Is your employer willing to fund your participation *

Yes No

If you do not receive financial assistance, are you still interested in enrolling in the Community Leadership Program and being responsible for paying tuition? *

Yes No

If you were able to provide a portion of the tuition, how much would you be able to contribute? *

Why should the committee consider offering you a scholarship? *

2022 Program Sponsors

American Woodmark, Dr. Dave Leadership Corp., Grafton, H.N. Funkhouser/Handy Mart, Navy Federal Credit Union, James Imoh – Edward Jones, Financial Advisor, Tech Team Solutions, TWG/The Winchester Group, Winchester Printers

Community Leadership Program 2022 Scholarship Request Form

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