Scholarship

We request that you please fill out our online membership form for 2023-2024 in order to help us to expedite the scholarship process. After filling out the membership form, please fill in the below details:

*Please note: credit card payments will not be processed immediately; receipt will be sent once credit card is charged.

Scholarship Request Form

Date

Name(Required)

First Last

Phone(Required)

Please describe, in detail, the reason for your request:(Required)

We truly want to welcome everyone who wants to be part of our community. By filling out this form, you are letting us know that the financial commitment that we have asked for would be a barrier to you becoming a member this year. CBI’s scholarship funds are limited and our operating expenses continue to increase. We ask that you pay the maximum amount you are able. Membership and Fees can be viewed here: https://www.cbi18.org/membership/becoming-a-member/

Amount of total CBI 2023-2024 membership and fees:(Required)

Amount you agree to pay CBI for 2023-2024 membership and fees (this amount must include the mandatory security and maintenance fees of $100 for singles or $200 for couples):(Required)

Digital Signature(Required)

Payment will be made by:(Required)

Check in full

Check in payments

Credit Card

Credit Card in payments

Number of monthly payments:(Required)

Credit Card Number (visa or mastercard):(Required)

Expiration Date:(Required)

Security Code:(Required)