Take Me to the Kaaba Scholarship Application Form

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Thank you for your interest in our Take Me to the Kaaba: A Hajj Journey class. Please complete this application form if you need assistance with tuition and would like to be considered for a partial scholarship. There are a limited amount of funds available but we will do our best to help.

Email *

Date of Application *

YYYY

Name of Mother *

Name of Guardian (if different from parents):

Phone Number for Parent: *

Mailing Address for Parent: *

Household Income in U.S. Dollars *

$0-25,000

$25,000-50,000

$50,000-75,000

$75,000-100,000

$100,000+

Other:

Numbers of People in your Household *

What is the nature of your work income? *

Is there any special circumstances that should be taken into consideration? *

Name and Birth Date of Participating Child #1: *

Name and Birth Date of Participating Child #2:

Name and Birth Date of Participating Child #3:

Name and Birth Date of Participating Child #4:

Name and Birth Date of Participating Child #5:

Thank you for your scholarship application. We will review the details and get back in touch with you asap. If you have additional questions, please contact us by email at classes@soundvision.com.

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