Scholarship Application

indicates a required answer

NOTE: You must submit an application for enrollment prior to applying for a scholarship. If you have multiple children, you will need to submit a separate application for each child.

Applicant Information

1. *	Student's Full Name:

2. *	Date of Birth:

3. *	Grade Applying For:

4. *	Parent/Guardian Name(s):

5. *	Address:

6. *	City, State, Zip Code:

7. *	Email Address:

8. *	Phone Number:

Financial Information

9. *	Annual Household Income:

10. *	Number of Dependents in Household:

11.	Additional Sources of Income (if any):

List any significant financial obligations:

12. *	Mortgage/Rent:

13. *	Medical Expenses:

14. *	Education Expenses (other children)::

15. *	Other:

16. *	Describe any unique circumstances affecting your financial situation (e.g. job loss, medical expenses, etc.):

Scholarship Information

17. *	Amount of Scholarship Requested:

18. *	Why do you believe this scholarship is important for your child's education?

19. *	How will this scholarship help your family?

20. *	Are you currently involved in any church or community activities? If yes, please explain:

References

21. *	Please provide the names and contact information of two references (not family members). Referece Name #1:

22. *	Relationship:

23. *	Phone Number:

24. *	Email Address:

25. *	Reference Name #2:

26. *	Relationship:

27. *	Phone Number:

28. *	Email Address:

Agreement and Signature

I hearby affirm that the information provided in this application is accurate and complete to the best of my knowledge. I understand that any misrepresentation or omission may result in the disqualification of my application.

29. *	Parent/Guardian Signature:
	By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

30. *	Date:

Submission Instructions:
Please submit this completed application on/before June 1, 2025.