Episcopal Cursillo in the Diocese of Virginia

Scholarship Form

To request a partial scholarship from ECDV to attend a Cursillo Weekend, please provide the following information and attach it to the Candidate Application. ECDV policy requires that the Applicant and/or Sponsor contribute at least one-third of the total cost and that the local Cursillo community and/or home church contribute at least one-third of the total cost. Then upon submission of the following information and the approval by the Applicant's Rector, the ECDV Secretariat will consider providing the remaining one-third of the cost ($50.00) to attend the Cursillo Weekend from the Scholarship Fund. (Effective 11/15/98, the cost of a Cursillo Weekend is $150.00 plus the Sponsor fee of $25.00.) Because ECDV scholarship funds are limited, the local community is encouraged to provide scholarship assistance whenever possible.

Applicant's Name:_______________________________________________________

Address:______________________________________City/State/Zip:______________________________

Home Phone:___________ Business Phone:____________ E-mail________________

Sponsor's Name:________________________________________________________

Address:_____________________________________City/State/Zip:_______________________________

Home Phone:___________ Business Phone:____________ E-mail________________

Church:_______________________________________________________________

Rector'sName:__________________________________________________________

Church Address:________________________________________________________

Church Phone:__________ Rector's Phone:____________ E-mail_______________

REQUEST/APPROVALS:
I hereby ask the ECDV for
scholarship assistance to
attend the Cursillo Weekend.
I support the request for
financial assistance.

I acknowledge the need
for financial assistance.

______________________/_______
Applicant's Signature/Date
______________________/_______
Sponsor's Signature/Date
______________________/_______
Clergy Signature/Date
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FOR ECDV CONSIDERATION: Scholarship: $50.00 Secretariat Approval:_________________Date:_________
Revised: 4/20/03

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Last Modified on 05/11/03