Project Explore 2008 Scholarship Application

Partial Scholarships will be awarded for one course only. Students who register for two courses will be responsible for full cost of the second course.

Name of Student:________________________________________________________

Age:____________ Grade in 2007 - 2008:______________

Parent or Guardian: ______________________________________________________

Home
Address:________________________Town:__________________Zip:_______

Day Phone:________________

Night Phone:_____________________

EMail:_____________________

Number in the immediate family residing in household:_____

Check if applicable.

Currently receiving ____ free lunch ____ reduced lunch

I give permission for Project Explore Directors to contract the school to verify this information.

_________________________________________

Parent/Guardian's Signature

If your child is not receiving free or reduced lunch please explain your need for financial assistance on the reverse side.

Must be received by:
Tuesday, May 13, 2008

Return to:

University of Maine at Presque Isle

Conferences & Special Programs

181 Main Street

Presque Isle, ME 04769

Fax to: (207) 768-9507

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