I declare that these statements are true, and I am able to show records of the above information.

I don’t know

No

Yes

Medicaid

I don’t know

No

Yes

SNAP

I don’t know

No

Yes

Free/reduced lunch

Does your student receive:

No -

Yes -

If yes, skip next section & click submit below.

If no, complete next section.

Is your student in foster care?

No - If no, skip next section & click submit below.

Yes - If yes, complete next section.

Are you applying for a scholarship?

Follow the promts and type an X in the associated box to determine your scholarship eligibility.

Scholarship Information

General Information

Please provide your contact details to receive a follow-up call from our office. If you are interested in scholarship opportunities, kindly complete the financial section

INTEREST FORM