Scholarship Application Form

We want every student to have the opportunity to participate in the

many events that are offered by the Student Ministries at Crossroads.
Please complete this form and return it to the Student Ministries Office
at Crossroads. This does not guarantee that scholarship funds will be
available, but is the first step in the If you have any questions, please
contact Sten Carlson at 970.203.9201 x8208.

Student Name

Parent/s Name

Address

City State Zip

Home Phone Cell Phone

Event Applying For

Event Cost

How much are you able to contribute?

How much scholarship money are you applying for?

Have you participated in any fundraising?

If so which one/s

Applicant's Signature Date

_____________________________________________ ______________________________
Parent/Guardian Signature Date

Thank you, we will contact you soon.