Women’s Retreat Scholarship Application

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Name:*

First Last

Phone:*

Email:*

Home Church:*

Home Church Location:*

Is this your first time at a Dakota Conference Women'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?*

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?*

How did you hear about this event? What individual can we thank for inviting you?*

Additional information you would like to share: