Scholarship Application Form

Scholarship Purpose and Procedure

The Middleton Counseling Center believes quality counseling should be available to all people. Scholarships are offered as a way of fulfilling this belief. Scholarships are available for individuals, couples, or families who cannot pay the full fee for their counseling services. Participation in the scholarship program is voluntary.

To apply for a scholarship please complete and submit the below application along with the necessary documentation. Scholarship applications will not be considered until all documentation is submitted.

Confidentiality
The Middleton Counseling Center maintains the confidentiality of all information provided. The Center retains the information from this application and your appointment dates. No additional information is collected or shared with the Center.

Application Information:

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Next Steps:
The scholarship will be reviewed. Once all documents are submitted, a determination will be made within one week. Both you and your practitioner will receive a letter with the determination of your application. If approved, all scholarship funds will be paid directly to the practitioner to support the cost of services.

Your application will be forwarded to Kiki McKendrick (KikiMckendrick@bmpc.org).