Washakie Museum & Cultural Center Youth Program Scholarship

Washakie Museum & Cultural Center

Youth Program Scholarship

Scholarships for museum youth programs are given at the discretion of Washakie Museum and Cultural Center employees. Scholarships must be awarded to children who have met the full requirements outlined by this application. If conditions are not met scholarship money will not be awarded. Please be sure to read carefully and fill out the application correctly. Incomplete applications will NOT be accepted!

Scholarships can either be partial (half of the cost of the program) or full.
Scholarships are limited and will be awarded to eligible students on the basis of availability.
To be considered for a scholarship a non-familial reference MUST be provided. For example, this reference can be a teacher, church leader, counselor, family friend, co-worker, or youth pastor. References are not required to pay any fees nor are they responsible for funding the child’s museum program experience.
Scholarship applications must be received at least 1 week prior to the program that you are requesting funding for.
Space in museum youth programs and scholarship funds are limited. For a better chance at receiving a scholarship for your desired program please submit this application as soon as possible!

Applications can be submitted online by completing the form below and clicking 'SUBMIT'; or by downloading and sending the completed application to: curator@washakiemuseum.org or
Washakie Museum and Cultural Center
Attn: Stefanie Kowlaczyk, Curator
2200 Big Horn Ave.
Worland, WY 82401

Youth Scholarship Online Application

Student Information:

* Indicates required field

Student Name *

First

Last

Birthdate *

Grade *

Program you are requesting assistance for: *

How much financial assistance are you requesting? *

In the student’s own words: Why do you want to attend this program? [We prefer the student write this, but adult help is not off limits]. *

Reference:

Reference Name *

First

Last

Phone Number *

email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Relation to Student *

To be completed by parent or guardian:

Parent/Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Number of adults in household: *

Number of children in household: *

Do you receive any state or federal assistance (WIC, SSI, Food Stamps, School Lunch)? *

Yes No

Please indicate other situations which may affect your household’s income: *

Verification *

I hereby verify that the above information is true and correct to the best of my knowledge.

Parent/Guardian Signature *

Date *

SUBMIT

Washakie Museum & Cultural CenterYouth Program Scholarship

Youth Scholarship Online Application

Washakie Museum & Cultural Center

Youth Program Scholarship