Scholarships for Re-entry Students Print out this form and mail it to Adult Student Grants, C/O WD Communications LLC, P.O. Box 2001, Fullerton, California, 92837.

Date: ____________________________________
Name: ____________________________________
Company/Institution: ________________________
URL: _____________________________________
Street Address: ____________________________
City: _____________State_____ Zip Code_______
Telephone: _____________ Fax: ______________

E-Mail Address (Required): ___________________

(Please print e-mail address clearly to ensure receipt of the report . The report is in Adobe Acrobe Reader format only. )


______ Payment by Check/Money Order (Payable to WD Communications LLC)

______ Please e-mail me the special report, Scholarships for Re-entry Students: Grants and Retraining Assistance for Adults Returning to College (89 pages). Enclosed is $39.95. Please allow two to three weeks for payment processing.