Women's Retreat Scholarship Application

Name:

Phone:

Email:

Home Church:

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 No

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: