Leslie Science & Nature Center
School Scholarship Application Form
Leslie Science & Nature Center is excited to offer Scholarships to schools thanks to the generous support of
our donors. This funding is limited and will be distributed based on need until depleted.
Please fill out the application below by October 3 to qualify for our first review of applications.
Turn in your application by fax to 734-997-1072 or email info@lesliesnc.org
Incomplete applications will not be considered.
We will notify you by October 17 regarding the status of your application.
Scholarships are limited to one program per classroom per school year.
Date: ________________ School name: _______________________________________________________
Teacher name: ___________________________________________________________________________
Teacher phone: ____________________________Teacher email: __________________________________
Total number of students: _________ Grade: ___________ Total number of chaperones: _______________
Our scholarships are awarded to schools in need of financial assistance, based on the percentage of
students receiving free and reduced-price lunches at your school.
______ % of students qualifying for the free lunch program at your school.
______ % of students qualifying for the reduced-price lunch program at your school.
Our scholarships provide partial coverage of program costs; you are responsible for all remaining
costs. Payment is expected on or before the day the program of unless prior arrangements have been made
with the LSNC office.
Three types of scholarships are available; each classroom is eligible for one of the types listed below. Please
check the type your classroom is interested in receiving:
______ Outreach Programs - We come to you! - 75% off the regular price.
______ Field Trip Programs - You come to us! - 50% off the regular price.
______ Bus reimbursement for Field Trips - 100% reimbursement, up to $100 per classroom
Please tell us which field trip or outreach program you are interested in:
Scholarships do not include Leslie Science & Nature Fest or custom animal programming.
Scholarship programs are limited to November – March.
What month(s) are you interested in?
________________________________________________________________________________________
How does this program fit into your curriculum?
________________________________________________________________________________________
Leslie Science & Nature Center | 1831 Traver Road, Ann Arbor MI 48105
info@lesliesnc.org | 734-997-1553 | www.lesliesnc.org
Why do you feel this program will provide an important experience for your students?
I have read and understand Leslie Science & Nature Center's Cancellation Policy and I agree to its terms and
conditions. I understand any non-weather cancellation less than 48 hours in advance of a scheduled
Scholarship-supported program will lead to forfeiture of all future Scholarship funds. I agree to call LSNC 48 or
more hours in advance if my class cannot make it to the program. Teacher's initials: ________
I understand and am committed to students creating thank you cards and submitting them to LSNC so we can
pass them along to Scholarship program donors. Teacher's initials: ________
Teacher's signature: _____________________________________________
Teacher's name: ________________________________________________
Principal’s signature: _____________________________________________
Principal’s name: ________________________________________________
Leslie Science & Nature Center | 1831 Traver Road, Ann Arbor MI 48105
info@lesliesnc.org | 734-997-1553 | www.lesliesnc.org