Scholarship Application Form – Leadership Greater McHenry County

Leadership Greater McHenry County Mission To connect, educate and inspire leaders to engage in our community.

CONFIDENTIAL SCHOLARSHIP FORM

Application Deadline: May 1, 2024

Leadership Greater McHenry County has scholarship funds available. Awards are based on your statement of need and amount of funds available, and must be requested at the time of the application. Every request will receive confidential, thorough, and fair assessment; every effort to be supportive will be made. Leadership Greater McHenry County offers only partial financial assistance and only to those individuals who clearly cannot otherwise afford the $3,975.00 tuition.
Your request for tuition assistance in no way influences the selection process and is totally confidential. Each request will be reviewed independent of the selection process and will have no affect on selection.
To ensure that we make equitable and informed decisions about tuition assistance, please complete the attached form.
The completed form should accompany your program application and must be received in the Leadership Greater McHenry County office with your application no later than May 1, 2024
Questions may be addressed to Marcy Piekos, Executive Director at (815) 337-8750 or mpiekos@leadershipgmc.org

Leadership Greater McHenry County Mission:
To connect, educate and inspire leaders to engage in our community.
Confidential Form for Leadership Greater McHenry County Scholarship
The information you provide below will help to accurately assess your financial need and make an allocation based on both need and available resources. To be considered for financial aid all questions must be answered. All information you provide remains confidential.

First Name*

Last Name*

Organization

Phone*

Email*

Please state why you are seeking tuition assistance*

Your income/salary*

$25,000 or under
$25,001 - $40,000
$40,000 - $55,000
$55,001 - $70,000
$70,001 - $85,000
$85,001 and over

I have sought partial tuition from other companies/organizations and civic leaders in my local area.

Yes
No

Anticipated sources of support for tuition (check all that apply):

Employer
Community Organization
Church
Self
Other
If non-profit, Board of Directors

LGMC offers limited scholarship, never the full tuition amount. Amount of assistance sought (this question MUST be answered):

What is the amount you are requesting?*

What amount will your employer/sponsor contribute?

How much will you personally contribute?

Are you employed by a non-profit organization?*

Yes
No

If your answer is “yes,” then please select one of the following:

Small (budget less than $250,000)
Medium (budget between $250,001-$600,000)
Large (budget of more than $600,000)

If tuition assistance is not available, will you be able to participate in LGMC?*

Yes
No

Describe any special circumstances for us to consider in your request for tuition assistance.

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