Pre-K Scholarship App - Greater Pike

Step 1 of 5

Is your child ELIGIBLE?*

My child is currently 3-6 years old AND

I earn less than $116,055 annually (for each dependent child add $20,428)

Student Information

Last Name*

First*

M.I.*

Date of Birth*

Gender*

Male

Female

Other

Student Address*

Verification Signature*
I certify that all of the included information is true and correct, all income is reported, and the income documents enclosed provide a true and accurate verification of my annual household income. I understand that the deliberate misrepresentation of the information may result in the scholarship being denied or terminated and may subject me to prosecution under State and Federal laws. I understand that the grant payments will continue for one year only as long as my child is enrolled at the school, my family continues to qualify under the scholarship income guidelines, and I stay current on the tuition balance. Any unused portion of the scholarship award, for whatever reason, must be refunded to Greater Pike Community Foundation (GPCF). Further, I understand that the scholarships are awarded according to the prioritized selection of the qualified applicants, as per the guidelines, and that the grant awards are the sole responsibility of GPCF, and all decisions are final. I agree to have my child's past and current progress reports released by the school to GPCF for program evaluation. I agree to release GPCF, and its Board of Directors and employees or partners, from any liability in its efforts to provide these educational grants which are renewable annually at the sole discretion of GPCF.
Parent / Guardian Name

Date
MM slash DD slash YYYY

Upload Tax Return*
Max. file size: 512 MB.
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Pre-K Scholarship Application

Pre-K Scholarship Application

Student Information

STUDENT SCHOOL INFORMATION

Parent / Guardian Information

Household Income Information

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