Scholarship Application

Please complete the application below in order to receive a scholarship through The Nehemiah Project. All applications will be subject to the approval process, and applications do not guarantee that a scholarship will be granted.

Name*
First Last
Email*
What is your marital status?*
Do you have dependent children living in the home with you?*
- Yes
- No
- Part-time
What type of a scholarship are you seeking?*
- Recovery Program
- General Counseling
- Marriage/Pre-Marital Counseling
Why are you unable to contribute toward the cost of your counseling / Recovery Program at this time?*
Are you currently employed?*
- Yes
- No
What is your current job?*
How many hours per week do you work?*
What is your monthly income?*
How much do you pay monthly for your rent/mortgage?
How much do you pay monthly for your utilities (water, gas, garbage, electricity)?
How much do you pay monthly for your cell phone?
How much do you pay monthly for your cable / internet?
How much do you pay monthly for your transportation (car note, insurance, gas)?
How much do you pay monthly for healthcare (insurance or otherwise)?
How much do you pay monthly for food / groceries?
How much do you pay monthly for childcare?
Do you have any other fixed expenses that you pay on a monthly basis? If so, please itemize below:
What are you currently doing to seek & secure employment?*
What is your current living situation, and how are you able to afford it?*
How are you currently paying for your other living expenses (such as utilities, cell phone, food, etc.)?*
Is there anyone else in your life / household who may be able and willing to help you pay for your counseling / program?
If so, have you approached them to ask for assistance yet?
Our scholarship program provides limited assistance to approved applicants - it does not cover the entire duration of counseling and/or Recovery Programs. What steps will you take in the next 30 days to move toward being able to pay for the cost of your services? (Please list 3)
Please upload your most recent bank statement:
Max. file size: 2 GB.

Scholarship Application

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