MTSA Parent Scholarship Application If you are human, leave this field blank. County and Region * Alcona – Region 1 Alger – Region 5 Allegan – Region 3 Alpena – Region 1 Antrim – Region 1 Arenac – Region 2 Baraga – Region 5 Barry – Region 3 Bay – Region 2 Benzie – Region 1 Berrien – Region 3 Branch – Region Calhoun – Region 3 Cass – Region 3 Charlevoix – Region 1 Cheboygan – Region 1 Chippewa – Region 5 Clare – Region 1 Clinton – Region 2 Crawford – Region 1 Delta – Region 5 Dickinson – Region 5 Eaton – Region 2 Emmet – Region 1 Genesee – Region 2 Gladwin – Region 1 Gogebic – Region 5 Grand Traverse – Region 1 Gratiot – Region 2 Hillsdale – Region 3 Houghton – Region 5 Huron – Region 2 Ingham – Region 2 Ionia – Region 3 Iosco – Region 1 Iron – Region 5 Isabella – Region 2 Jackson – Region 4 Kalamazoo – Region 3 Kalkaska – Region 1 Kent – Region 3 Keweenaw – Region 5 Lake Leelanau – Region 1 Lapeer – Region 2 Lenawee – Region 4 Livingston – Region 2 Luce – Region 5 Mackinac – Region 5 Macomb – Region 4 Manistee – Region 1 Marquette – Region 5 Mason – Region 1 Mecosta – Region 2 Menominee – Region 5 Midland – Region 2 Missaukee – Region 1 Monroe – Region 4 Montcalm – Region 3 Montmorency – Region 1 Muskegon – Region 3 Newaygo – Region 3 Oakland – Region 4 Oceana – Region 3 Ogemaw – Region 1 Ontonagon – Region 5 Osceola – Region 2 Oscoda – Region 1 Otsego – Region 1 Ottawa – Region 3 Presque Isle – Region 1 Roscommon – Region 1 Saginaw – Region 2 Sanilac – Region 2 Schoolcraft – Region 5 Shiawasee – Region 2 St. Clair – Region 4 St. Joseph – Region 3 Tuscola – Region 2 VanBuren – Region 3 Washtenaw – Region 4 Wayne – Region 4 Wexford – Region 1 Parent First * First Parent Last * Last Email * Phone * Mailing Address * Mailing Address Mailing Address Mailing Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Applicants.... * must be a parent of a child with a disability may not be employed by a school district, ISD or Agency. must have a funding need that is not met through other sources Are you a current MTSA member? * Yes No Signature * Clear Submit
