Community Access Fund- Scholarship Request
Thank you for your interest in our education programs at the Farm! Our Community Access
Fund is our way of ensuring everyone has access to our many community program offerings.
Please complete this form and return at least one week prior to the event or program start
date.

All information will be reviewed by the Education Director and be kept confidential.
Please allow a week for processing your request. You will receive an email confirmation of your
scholarship receipt and any directions related to your selected program. If you have any
questions, please do not hesitate to contact our Education Director at
Sarah.Miles@pitneymeadows.org
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Your name *
Phone number *
Email address *
Is this scholarship request for... *
If the request is for you, please skip this section. If it is for someone else, please provide recipients relationship to you.
What is their name?
Are they a minor?
Clear selection
Name of requested program or event *
Date of event or start date of program *
MM
/
DD
/
YYYY
Briefly share the basis for your request *
Submit
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