Midweek Mania Scholarship Application

Your name *

Email address *

Phone number

Where do you attend church? *

How did you hear about Midweek Mania? *

Employment status: *

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: *