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Scholarship Application

To apply for a scholarship for the 2012 UCCMNN conference, please complete the following information.  Five scholarships are available.  To be eligible, you must be from a "small" church.  The definition of a "small" church is under 75 in attendance at worship.  Scholarship will cover the cost of registration ($179.00) as well as an additional $221.00 (for a total of $400) to be applied toward housing costs at the host hotel.  Please do not register for the conference until you hear back about your scholarship application (by March 30th or before).  Applications are due by March 25, 2012.

Name
Street Name
City, State
Zip Code
Home Phone
Cell Phone
Email Address
Church Name
Church Street Name
Church City, State
Church Zip Code
Position Held at Church
Average Weekly Worship Attendance
Please briefly describe your reason for needing scholarship assistance
     
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