Scholarship Application

top of page

Use tab to navigate through the menu items.

Guardian First Name

Phone

Teen's Name

Guardian Last Name

Email

Teen Age/Grade

Are you requesting scholarship for: * Required

Partial Assistance

Full Assistance

Unsure

Briefly share why you are requesting a scholarship at this time:

Anything else you would like us to know?

Acknowledgement * Required

I understand scholarships are limited and based on availability.

I understand this program is not counseling or therapy.

I understand I will be contacted regarding the status of this request.

(918) 696-2181

76840 Highway 59

Stillwell, OK 74960

bottom of page