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DLTI Week Three - Summer 2017 Scholarship Application

 

Scholarships are awarded on a first-come, first-served basis.

We will respond to requests for scholarships within seven business days of receipt of this application. A scholarship offer does not guarantee room availability at the time of registration. Please register promptly. 

If you have any questions, please contact the Registrar at registrar@hazon.org or (860) 824-5991 ext. 0.

  Contact Information

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Name:

 

 

   

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ZIP / Postal Code:

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Date of Birth:

 

Please answer the following questions so that we can have an accurate understanding of your financial situation:


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Question - Required - How many adults are in your household?



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Question - Required - How many children are in your household?




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The following questions are specific to this retreat:


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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

 

Thank you for applying for a scholarship. Please add registrar@hazon.org to your address book to assure that our response does not end up in your junk mailbox.

   Please leave this field empty