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Midweek Mania Scholarship Application
Your name
*
Last name
Email address
*
Phone number
Phone type
Mobile
Home
Work
Other
Where do you attend church?
*
Select…
Harvest Bible Chapel - Aurora
Harvest Bible Chapel - Chicago Cathedral
Harvest Bible Chapel - Crystal Lake
Harvest Bible Chapel - Elgin
Harvest Bible Chapel - North Shore
Harvest Bible Chapel - Rolling Meadows
Not Currently Attending
Other
How did you hear about Midweek Mania?
*
Select…
Returning Family, HCA, or Harvest Bible Chapel Family
I was invited by a friend/family
Other
Employment status:
*
Select…
Full-time
Part-time
Currently not employed
How many children would you like to request a scholarship for?
*
min: 1 / max: 4
Please provide their names and birthdates.
*
What is the maximum amount you can contribute to each child's registration fee of $30?
*
min: 5 / max: 30
Please tell us why a scholarship would be helpful:
*
Submit
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