Little Acorns Nature Preschool Scholarship Application

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
- No
How many children do you have besides the one(s) you are enrolling?*
Have you volunteered at Dahlem before?*
- Yes
- No
If yes, please explain:*
Please provide your gross income as listed on your 2022 Federal Tax Return*
Please provide the pages 1 & 2 of your 2022 1040 Federal Tax Return*
Please make sure you provide proof of 2022 gross income
Max. file size: 40 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
- No
If yes, what dollar amount per month?
Thank you for your application. If you have any additional questions, please contact our Lead Preschool Teacher and Preschool Program Director, Kayla Sipe at 517-782-3453 ext. 107 or ksipe@dahlemcenter.org

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