LBC Member Scholarship - Lighthouse Baptist Academy

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

After selecting the applicable number, please complete the necessary information for each student.

Number of Students(Required)

Note: In the "Grade" information box, please put the grade the child is entering.

Please enter a number greater than or equal to 0.

Full Name of Student 1

Grade of Student 1

Full Name of Student 2

Grade of Student 2

Full Name of Student 3

Grade of Student 3

Full Name of Student 4

Grade of Student 4

Full Name of Student 5

Grade of Student 5

Full Name of Student 6

Grade of Student 6

Member Identification(Required)

I agree

I, the undersigned, agree that I am a member in good standing of Lighthouse Baptist Church (or a campus of LBC)

Signature(Required)