Spring College Scholarship Question Title * Information First Name Last Name Employer: Child Care Program Child Care Program License Number Child Care Program Address City Zip Code Applicants Email Address Applicants Phone Number Question Title * College Information Name of College or University you are enrolled in Student ID Number Course Number Course Name Question Title * Policies and Statements We agree that the applicant will use this scholarship to enroll in a class that has a direct relationship to providing quality child care or child care administration. We agree that the applicant will notify Collaborative for Children within 5 work days if he/she drops the course and will provide any assistance required to secure a refund from the college or university. The refund must be paid to Collaborative for Children or the applicant will not be eligible for future scholarships. We agree that the applicant will send proof of final grade received within two weeks from the class ending date. We attest that the applicant lives or works in one of the following 13 counties: Austin, Brazoria, Chambers, Colorado, Fort Bend, Galveston, Harris, Liberty, Matagorda, Montgomery, Walker, Waller, and Wharton. We agree to submit proof of enrollment within the first week of class. Question Title * I acknowledge that I have read, understand, and will abide by the above named policies,procedures, statements, and instructions. Yes Submit