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Breakaway 18 Financial Aid

please fill out the Financial Aid application for Breakaway 2018:

Once your application is submitted, you will receive a response within 5 days from Elevate Staff.  If you qualify for Financial Aid, you will be given a discount code to use with your Breakaway Registration.  

Student #1 Name *
Student #1 Name
Student #1 Birthday *
Student #1 Birthday
Student #2 Name
Student #2 Name
Student #2 Birthday
Student #2 Birthday
Student #3 Name
Student #3 Name
Student #3 Birthday
Student #3 Birthday
Parent/Guardian Information
Parent Name *
Parent Name
Parent Address *
Parent Address
Parent Phone *
Parent Phone
Parent/Guardian Spiritual Involvement
Do you currently attend Willow Creek Community Church? *
How many weekend services have you attended in the last 3 months? *
Assistance History
Have you previously requested financial aid from one of the following ministries? *
Parent/Guardian Employment Information
Check any of the following that apply to either you or your spouse: *
Parent/Guardian Finances
Monthly Household Income *
Please include paychecks, child support, unemployment, disability, and social security.
Please do not guess. Monthly fixed expenses include but are not limited to: housing, communication, utilities, insurance, auto, household and personal items, professional services (childcare, medical, legal), debt repayment, and education expenses.
Are there major medical expenses affecting the family's finances? *
What is the current sum of your liquid assets? *
Including checking accounts, savings accounts, and cash.
What amount can you pay of the registration per child? *
Please remember that while we would love to give financial aid to everyone in need, we have limited funds to work with.
Release Statement
By checking the box below, I (we) state that I (we) understand that Elevate will attempt to assist me (us) in addressing my (our) current financial aid request. I (we) acknowledge that consulting with Elevate may involve the sharing of my (our) information with other ministries of Willow Creek Community Church on a "need to know" basis. I authorize such sharing of information within Willow Creek Community Church. Willow Creek affirms the need to keep this information confidential, and will not share the information with anyone outside of Willow Creek ministries.

In consideration of receiving assistance from Willow Creek Community Church in addressing my (our) current scholarship request, I (we) release and forever discharge Willow Creek Community Church, its former and present officers, directors, pastors, elders, employees, volunteers, members, and agents from any claim, suit, action, demand, or liability of any kind arising out of, or in any manner connected to, my (our) participation in Elevate services. *