Rhinebeck Campus
Scholarship Application
Just fill this out and submit when finished! Required fields are marked with an asterisk (
*
).
Name:
*
Mailing Address:
*
City:
*
State:
*
Zip:
*
Telephone A.M:
*
Telephone P.M:
E-mail:
*
Occupation
Employer:
Gender:
Female
Male
Age:
18-25
26-34
35-45
46-59
60-69
70 and over
Ethnicity:
Black / African American
Asian / Pacific Islander
Hispanic/Latino
American Indian / Alaskan native
White / Caucasian
Multi - ethnic
Other, please specify:
Income Eligibility
(please see
income guidelines
)
Total Household Gross Annual Income
as reported on most recent tax forms:
*
Total number of people in household (as shown on tax forms):
*
Please list dependent name(s) and age (s) of children
only if they will be accompanying you:
Name:
Date of Birth
Name:
Date of Birth
Name:
Date of Birth
Course Selection:
Which course are you applying for?
Course #
Title/Faculty:
Dates
Tuition Cost
Materials Fee (if applicable)
Please note:
Only
one
scholarship per applicant will be awarded (pending eligibility and availability of funding).
Housing
If you would like a Tent Cabin and are able to bring your own sleeping bag, please check here
If you are able to provide your own tent and/or sleeping bag, please check here
If you will be commuting and will be staying off campus, please check here
Personal Essay
The determining factors in awarding scholarships consist of the financial need, personal need and/or professional commitment of each applicant. Please take the time to briefly describe why you would like to be considered for an Omega scholarship.
*
Special Needs
Please describe any special needs you have:
Thank you for the interest you have shown. Your request is important to us and will be carefully considered. By completing this application you certify that all of the above information is true and correct and that all income is reported. This information will be kept strictly confidential and will only be used in determining scholarship eligibility. You will be notified through the mail of the status of your application. We ask that you do not call unless the full six weeks of processing time has elapsed. Thank you for your patience.