Scholarship Application

denotes required fields.

Contact information

First name

Last name

Address 1

Address 2

City

State

Zip /Postal Code

Phone number

Preferred form of contact

Phone

Scholarship information

Are you currently an OLLI at MSU member?

Yes

Would you like financial assistance with a course? If so, type the name of the course and the amount of assistance desired.

Would you like financial assistance with membership? If so, type the amount of assistance desired up to $23.

Please provide a brief explanation about why you are requesting this scholarship support.

If you have received an OLLI scholarship in the past, please provide the date.