Scholarship Application Form
(for students 18 & under)
Email Address (required)
Student Name
Student Birthday
Parent/Guardian
Phone Number
Address
City
State
Zip Code
Yearly Household Income
Select One...
$0-$10,000
$10,001-$15,000
$15,001-$20,000
$20,001-$25,000
$25,001-$30,000
$30,001-$35,000
$35,001-$40,000
$40,001-$45,000
$45,001-$50,000
$50,001-$60,000
$60,001 & above
Members in Household
What School Does Student Attend?
Session Applying For?
Select One...
Spring
Summer
Fall
I agree to fulfill my volunteer hours, make any partial payments required and consistently bring my child to class on time. I understand that once my child takes a class after the granting of a scholarship, I am obligated to fulfill the terms of the scholarship regardless of how many classes my child may miss. I also understand that if these terms are not fulfilled by the beginning of the next session, I will be obligated to pay the standard class fees.
I Agree (check for "Yes")