FINANCIAL AID APPLICATION
NOTE:  All expenses of Mentor Couples will be paid by CPM.

Download Financial Aid Form (Word Format)
Or fill out the form below and submit.

His Name:   Date of Birth
Her Name:   Date of Birth
Address:   State  Zip
Phone: email:

Have you completed an application for the 2009 CPM Marriages and Mentors Conference?    Yes, If not, please complete the conference application before submitting this financial aid form.

The CPM conference is free of charge and includes all meals and transportation while in Midland. You are responsible for your travel to and from Midland and for your lodging.

Please describe the financial aid you are requesting:
Assistance with travel expenses: Y /N
If yes, please describe the extent of assistance you are requesting (include the estimated cost of travel expenses and the amount of assistance you are requesting): 

Assistance with lodging expenses:  Y /N
If yes, please state the amount of assistance you are requesting:   

Briefly describe any special circumstances in your family that have resulted in your need for financial assistance:

Signature Date
Signature Date