LDA - Scholarship Application

LEADERSHIP & DIALOGUE ACADEMY
Scholarship Application

The Leadership and Dialogue Academy makes every effort to award financial aid when circumstances require it. Our staff reviews each application in confidence and makes award decisions based on the information you provide in this form. Please be as through as possible to ensure your circumstances are best represented.

Summer scholarship applications must be received by our office no later than June 1, 2021 including the tax form to be delivered via to lda@pinnaclepres.org.

Please note that all scholarship applications will require submission of the first page of the parent/guardian’s most recent 1040 US Tax Form, showing Adjusted Gross Income (AGI). Please email to lda@pinnaclepres.org. Scholarship decisions cannot be made without this required tax information.

Teen Name

First Name

Last Name

School Currently Enrolled

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Teen Email

Parent/Guardian Email

Parent/Guardian Phone

(###)

###

####

What do you hope to learn?

Please include a paragraph explaining what attending the Leadership and Dialogue Academy would mean to you? What do you hope to learn?

LEADERSHIP & DIALOGUE ACADEMYScholarship Application

LEADERSHIP & DIALOGUE ACADEMY
Scholarship Application