Application for Educational Scholarship
Please use this form only to request a financial waiver for paid classes, camps, workshops, educational events or weekend or after-school offerings held at the MCC.
MCC East Bay is empowered by its generous congregation to mandate a standing policy that financial need should never
hold back a community member or his or her family from partaking in any educational offering at the community center.
This includes classes, camps, Sunday School, weekend workshops, educational events and after-school Qur'an classes.
At our discretion, and based on the information you provide, MCC may subsidize or cover your cost by tapping its
Education, Sadaqa or Zakat accounts.
email@example.com 1. Primary Applicant Name * Email * Cell Phone * Have you applied for Zakat assistance or past financial aid for educational offerings at MCC? * What field of work are you working in now or were most recently employed in? * If working, company name? Salary Job Position If not working, explain why not? 2. YOUR HOUSEHOLD If married, name of spouse? Is your spouse currently employed? If working, company name? Salary Job Position Number of Dependents in Your Household * List each dependent's full name, their relationship to you, and their age: 3. Household Income & Expenses
Proof of income OR prior year’s tax return required only with all recurring classes/sessions OR if
a one-time MCC event fee is more than $50.00.
Monthly Gross Income Income From Work (you and your spouse) * Child Support Aid/Welfare, Food Stamp Family Government Assistance Other Sources Specify other sources: Total Monthly Gross Income * Monthly Expenses Rent/Mortgage * Utilities/Phone Food Car Payment/Insurance Medical Expenses Other (i.e. debts, loan payments) Specify other expenses: Total Monthly Expenses * Household Assets Checking * Savings Gold or Silver (cash value) Vehicle(s) (fair market value) IRA, Pension, Stock, Mutual Funds Other (cash value) Total Household Assets * 4. Scholarship Request For whom in your household are you applying for assistance? * For which educational offering at MCC are you seeking a scholarship? * What is the full listed price for this educational offering? * Of the full listed price, what price can you afford to pay? How would receiving a scholarship positively impact this person(s) or your household? Describe any additional or extenuating circumstances: Copy of California Driver’s License/Identification Card
Proof of Income
Either last three months pay stubs for myself, my spouse, & my children (only if there are children in my household who are working) or my last year’s submitted tax return.
Any additional documentation that might help in the evaluation of your application:
By entering my name below, I testify in front of Allah (SWT) that the information provided in this application is true and accurate to the best of my knowledge. I understand that if any information that I have given turns out to be untrue, my application will automatically be denied. Type Your Name *