Scholarship Fund Request

Are you currently or ever been in the Foster Care System?

Please provide case worker/ aftercare worker name, email and phone.  If none, please explain.


Please describe the intended use of the JLCR Scholarship and why it is needed. 
If funding request exceeds $25.00 please attach any proof of expenses (ie: estimate, registration form, bill, etc.).

What other community resources have you utilized?

We affirm that the information provided in this application is true and complete to the best of our knowledge. I consent to the verification of information contained in my application. We understand that if selected, the scholarship will not be distributed to scholarship recipients.  Scholarships will be awarded in the form of gift cards or monies will be paid directly to debtors.