Opportunity Scholarships Application

EDU – Opportunity Scholarship

Form duplicated from CF7 2020.09.23 JS

Applicant Information
School Name*
School Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Educator Name*
First Last
Educator Email*
Enter Email Confirm Email
Educator phone*
work
Educator phone*
home
Educator phone*
cell
Principal Name*
First Last
Principal Email*
Enter Email Confirm Email
Field Trip Information
Number of Students*
Please enter a number greater than or equal to 10.
Number of Chaperones*
Number of Medical/Behavioral Aides*
Student Grade Level*
Confirmed Field Trip Date*
MM slash DD slash YYYY
Confirmed Field Trip Time*

: Hours

Minutes

AM/PM
Tour Option*
- In-Person Tour
- Virtual Tour
- Student Leadership Day
Financial Information
Has your school applied for a scholarship before?*
- Yes
- No
% of students within school building who currently qualify for free or reduced lunch*
Explain your financial need for an Opportunity Scholarship to visit the Illinois Holocaust Museum & Education Center*
Opportunity Scholarships Policy
I certify that the information provided in this Opportunity Scholarship application is true and accurate. I agree to comply with the terms and policies of the Opportunity Scholarship Program. I understand that if selected, my school will receive a waiver for admission fees and/or reimbursement for transportation costs (up to $2,000 & school W9 required) within 60 days of submitting receipts. To thank the Scholarship sponsor(s) and help ensure the continuation of the program, I will send a Letter of Acknowledgement with student feedback to the Museum within 30 days of my field trip.
I have read and agree to IHMEC's Opportunity Scholarships policies.*
- Yes
Email
This field is for validation purposes and should be left unchanged.

EDU – Opportunity Scholarship

Applicant Information

Field Trip Information

Financial Information

Opportunity Scholarships Policy

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