Youth Program Scholarship Form

Sandburg Youth Program Scholarship

Due to the generous support of individuals and businesses, we are pleased to offer a limited number of scholarships for our summer youth programs. Please contact 217.357.3129 ext:7243 with any questions.
Name*

First NameLast Name
Child's date of birth*
month, date, year
Parent/Guardian information*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Relationship to student*
Please describe why you would like to attend Sandburg's Youth Program(s) and what you hope to learn. This must be written by (or in the words of) the child applying for the scholarship.*
Scholarships are reviewed & awarded on a first-come, first-served basis. A full application must include free/reduced lunch documentation, and the program registration form must be completed in full and submitted no less than two weeks prior to the program start date in order to be placed on the program roster. Registration forms are available at sandburg.edu/youthprograms. Incomplete applications will not be reviewed. Applicants must meet income eligibility requirements, which includes documentation of participation in the free/reduced lunch program through the child’s school. Income eligibility requirements can be reviewed on the ISBE website at: https://www.isbe.net/Documents/IEG-22.pdf. Awards are subject to fund availability. Notification regarding any requests that cannot be accommodated will be provided prior to the class start date. For any costs that is not covered by the scholarship, please contact the college to make a payment or to cancel the registration no later than 1 week before the start of the program.

I have read and understand the above affirmation statement. Enter your name below, which will serve as your electronic signature:
Signature*

Clear
Please attach documents for review and scholarship consideration.*

Cancelof
Should be Empty:

Sandburg Youth Program Scholarship