Scholarship Application Form
Northland Recreation Laboratory
Application Date________________________________
Name_________________________________________________________________________
Address___________________________________City, State, Zip_________________________
Email Address______________________________Telephone Number_____________________
Please indicate:
____Attend full time
or
____Attend part time
____First time at Northland
or
___Return
Funds in the scholarship account are limited so the earlier you apply the better. After March 15 th Scholarship
Funds may be limited. Full time attendance scholarships are limited to a maximum of $200. Part time
attendance scholarships are limited to a maximum of $100.
Give a brief introduction of yourself, your history with, or how you heard about Northland Rec Lab:
If you are a returning Labber, please tell us how you would use your talents to contribute to the success of
Northland Rec Lab?
Amount Requested:___________
Please indicate why you are in need of scholarship funds.
__________________________________________________________________________________________
__________________________________________________________________________________________
Complete this application form in full and send to:
Northland Rec Lab
Carol Esnough, Registrar
P.O. Box 28086
Crystal, MN 55428
or
Email: cesnoughNRL@comcast.net
Phone: 763-537-0529