Fillable Continuing Education Lifelong Learning Scholarship Application (College of DuPage)

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Continuing Education Lifelong Learning Scholarship Application (College of DuPage)

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Continuing Education
Lifelong Learning Scholarship Application
College of DuPage Continuing Education is dedicated to serving the educational needs of all COD district residents.
Limited scholarship funds are available to assist lifelong learners who choose to participate in Continuing Education
programs. The majority of these funds are provided by the College of DuPage Foundation. Individuals who wish to
contribute to this fund are encouraged to contact Continuing Education at (630) 942-2208 or ce@cod.edu.
Available funds for these programs, per term are as follows: $200 maximum per household. Individuals must re-apply
each term. Scholarships are dependent upon funding availability.
Eligible individuals must satisfy the following criteria, in addition to submitting a completed application:
• Must be 50 years of age or older
• Must include a written statement describing why scholarship funds are being requested
Section I: Personal Information
Student Student ID # Date of Birth
Address City State ZIP
Home Phone Email
Section II: Class Information
Please list the class or training program for which you plan to register. All fields below must be filled in order for your
application to be considered:
Term:
Spring Summer Fall
Course Title: ______________________________ Section Number: _______________ Course Fee: ___________________
Please note: If your application is approved and the course chosen is unavailable, you will be given the option to choose another course in the same term.
Section III: Written Statement
Please provide a brief statement about why you are requesting Continuing Education scholarship funds.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Are you able to contribute a portion of the funds for your course?
Yes No If yes, what amount?_______________
Section IV: Certification
I certify that this is my permanent, legal address and that all information is true and correct to the best of my knowledge.
____________________________________________________________________________________________________________
Signed (Student) Date
Please return this application to:
College of DuPage
Continuing Education, SRC 1110
425 Fawell Blvd. • Glen Ellyn, IL 60137
Attn: Continuing Education Scholarships
(Continued)
CE-17-25162(7/17)200
Page 1 of 2
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Date Reviewed: _____________________________ Date Approved: _________________________ Initials: _______________________
Date Funds Applied: _________________________ Initials: _______________________
Student Registered:
Yes No Initials: _______________________
Student Payment Processed:
Yes No Initials: _______________________
Please return completed form to Scholarship mailbox.
Page 2 of 2
Lifelong Learning Scholarship (continued)
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Continuing Education Lifelong Learning Scholarship Application (College of DuPage)

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Completed 15 September 2020

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