Opportunity Scholarships Application

All fields are required


Applicant Information:

School Name:
School Address:
City:
State:
Zip:
Teacher Name:
Teacher Email:
Teacher Phone (work):
Phone (home):
Phone (cell):
Principal Name:
Principal Email:

Field Trip Information:

Number of Students:
Chaperones:
Medical/Behavioral Aides:
Student Grade Level:

Confirmed Field Trip Date:
(must apply at least 30 days before scheduled trip)
Confirmed Time:
Tour Option: In Our Voices (Grades 7-college) 160 students maxSelf Guided In Our Voices - Teacher-led TourBe an UpstanderMake A DifferenceStand Up Speak OutTake a StandTemporary Exhibit


Financial Information:

Has your school applied for a scholarship before?    
% of students within school building who currently qualify for free or reduced lunch:
Expected Cost of Admission ($8.00 x # of students) $
   
*Will not waive $50 deposit
 
Explain your financial need for an Opportunity Scholarship to visit the Illinois Holocaust Museum & Education Center:

What is the objective of your field trip?

How will your students benefit directly from the field trip?

How will the experience benefit your curriculum?

How will you measure student learning as it directly results from the trip?

I certify that the information provided in this Opportunity Scholarship application is true and accurate. I agree to comply with the terms and policies of the Opportunity Scholarship Program. I understand that if selected, my school will receive a waiver for admission fees and/or reimbursement for transportation costs, up to $1,000, within 60 days of submitting receipts. To thank the Scholarship sponsor(s) and help ensure the continuation of the program, I will send a Letter of Acknowledgement with student feedback to the Museum within 30 days of my field trip.

Please type the letters into the form:
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