Little Acorns Nature Preschool Scholarship Application (* must be an enrolled student)

"*" indicates required fields

Parent/Guardian Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Primary Phone*

Secondary Phone (Optional)

Email*

Number of Children You Plan to Enroll*

Child Name*

2nd Child Name

Are you, your spouse, or your children related to anyone on the Dahlem Center's staff or board of directors?*

Yes

How many children do you have besides the one(s) you are enrolling?*

Have you volunteered at Dahlem before?*

Yes

If yes, please explain:*

Please provide your gross income as listed on your 2024 Federal Tax Return*

Please provide the pages 1 & 2 of your 2024 1040 Federal Tax Return*

Please make sure you provide proof of 2024 gross income

Max. file size: 2 MB.

Please describe any personal circumstances that would make you eligible for a scholarship toward your child(ren)'s participation in the Little Acorns program:*

Would you be capable of paying a portion of your child(ren)'s monthly fees?*

Yes

If yes, what dollar amount per month?

Please note: the child must be an enrolled student in order for a scholarship application to be considered. If you have any questions, please contact our Lead Preschool Teacher and Preschool Program Director, Kayla Sipe at 517-782-3453 ext. 107 or ksipe@dahlemcenter.org

Little Acorns Nature Preschool Scholarship Application (* must be an enrolled student)

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