WWKC - KOI Scholarship Application Form

Scholarship *

WWKC Member Certified Koi Keeper Scholarship - only current WWKC members may apply

KOI Certified Koi Keeper Scholarship

Type of scholarship being applied for (check only one and only one application per person is allowed)

By submitting this form, applicant affirms that they have read and understand the Scholarship Conditions, Rules and Applicant Requirements (given separately) of the scholarships offered and agrees to all of them including the following:

A person may apply only once and for only one scholarship.
Applicant agrees to prepay $100 (US) tuition to KOI by 12/31/17 which will be refunded on completion of the nine (9) courses of the Certified Koi Keeper curriculum and certification by KOI within 6 months (6/30/18).
Applicant understands the out-of-pocket expenses associated with the scholarship for which applicant has applied and is willing and able to bear these expenses.

Applicant Information

First Name *

Last Name *

Koiphen Username *

Address *

* Address

Street Address *

Street Address

City *

City

State / Province / Region *

State / Province / Region

ZIP / Postal Code *

ZIP / Postal Code

Country *

Country

Email Address *

Date

If you are human, leave this field blank.