Osher Institute Scholarship Application

Scholarship Application

TODAY'S DATE:(Required)

YYYY

SCHOLARSHIP TERM:(Required)

Scholarships are available for up to two years with the Institute. An annual scholarship includes one year of membership, with one free fee-based course (up to $45 or $45 off a larger fee-based course with balance paid by the member) each semester. A spring-only scholarship is available for the spring semester of Osher programs (January 1-May 30), with one free fee-based course (up to $45 or $45 off a larger fee-based course with balance paid by the member). A partial scholarship is available at $30 off the regular membership cost. Payment for the remainder of the membership balance is due at the time of membership activation. Member receives programs indicated as “Included with membership” at no cost; programs with fees indicated are the responsibility of the Osher member.

Name and Contact Information

NAME:(Required)

First Last

ADDRESS INFORMATION:(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

EMAIL ADDRESS:(Required)

PHONE NUMBER:(Required)

Background Information

Please describe your interest in the Osher Institute.(Required)

Please briefly explain your financial situation in terms that allow the scholarship committee to understand your need for a financial scholarship. (Because fixed incomes vary widely, simply stating that you are on a fixed income is not sufficient.)(Required)

How many times have you received a FULL scholarship?(Required)

Once

Twice

Three times or more

I have not received a full scholarship in the past

How many times have you received a PARTIAL scholarship?(Required)

Once

Twice

Three times or more

I have not received a partial scholarship in the past

Age Certification

Financial scholarships are for individuals aged 50 and older whose financial situation precludes participation in the Osher Institute without scholarship assistance.(Required)

Please check to certify that you are 50 years of age or older at this time of your application.

Osher Institute Scholarship Application

Scholarship Application

Name and Contact Information

Background Information

Age Certification

Osher Lifelong Learning Institute