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TELL US ABOUT YOURSELF
First Name
*
Last Name
*
Company/Organization
*
Email Address
*
Phone
*
TUITION INFORMATION
Tuition for Leadership Winter Park - $2,750 (Chamber Member Rate)
Subtract amount to be paid by employer:
*
Subtract amount to be paid by you personally:
*
Balance is the amount of tuition assistance requested:
*
PERSONAL FINANCIAL INFORMATION
Please explain why you require financial assistance and should be considered for a partial scholarship.
*
What other sources of tuition assistance are you exploring/have you secured?
*
List your company/organization's total annual net revenue for the most recent fiscal year.
*
Since funds are limited, you are encouraged to seek a sponsor if you or your employer is not paying the full tuition. If you are not selected as a scholarship recipient, would you still like to be considered for selection as a class participant?
Yes
No
Those candidates which are selected to receive partial scholarship assistance are requested to contribute service to Leadership Winter Park by participating as an active volunteer for events benefiting the scholarship fund. Are you willing to serve this role as requested?
Yes
No
By checking these boxes, I understand:
Recipients of this scholarship are required to be or become a chamber member.
Recipients of this scholarship are required to serve on one LWP or Chamber committee and volunteer at two scholarship fundraising events during the Class term.
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