Playgroup Scholarship Application

Application deadline for Summer 2017 playgroups is June 20, 2017

Instructions: Please fill out the following application. If you are, or will be, a student during the semester you are applying for you must send a copy of your course schedule to angelam@lavc.edu. Your application will be incomplete until you do so. The schedule must clearly show your name, the semester, and list of courses. 

Parent/Guardian Name *
Parent/Guardian Name
Parent/Guardian Name
Parent/Guardian Name
Child 1 *
Child 1
Date of Birth *
Date of Birth
Child 2
Child 2
Date of Birth
Date of Birth
Contact information
Phone *
Phone
Playgroup Options
select your top playgroup option. *Note: You are not guaranteed the playgroup you select.
Student Information
Are you currently a student? *
Email copy of course schedule to lopezj@lavc.edu
Expected Degree Completion Date
Expected Degree Completion Date
How are you funding your education?
Check all that apply
Employment information
Answer the following questions:
Have you previously applied for this scholarship? *
Have you previously attended playgroups? *
Type name for signature.