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Leaf Pattern Design

Request For Scholarship

First name

Last name

Email

Phone

Class/ Wellness Service

Instructor/Practitioner

Date of service

Please tell us a little about why you want to take this class or receive this service and how a scholarship would help:

Scholarship amount requested:

Full (100%)

Partial

If partial, amount you can contribute: *Note Scholarships may cover up to 100% of the class fee based on need and available funds.

Today's Date

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©2021 by Winhall Community Arts Center

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