Men’s Retreat Scholarship Application

This field is for validation purposes and should be left unchanged.

Name:*

First Last

Phone:*

Email:*

Home Church:*

Is this your first time at a Dakota Conference Men's Retreat?*

How much money can you contribute to your registration fee?*

We ask that you speak to your local church about contributing to your registration fee. Have you done this and to whom have you spoken?*

Yes

How much money is your local church contributing to your registration fee?*

How much money are you requesting from the conference scholarship fund for your registration fee?*

Have you received conference scholarship assistance in the last 2 years?*

Additional information you would like to share: