Scholarship - PDF document

T he Guardsmen Scholarship Program “ Providing the key that opens the door to opportunity” The Guardsmen Scholarship Program is a privately funded program dedicated to broadening the educational opportunities for children of low - income families in the Bay Area. We provide tuition assistance for those families who wish to send their children to a private school. The scholarships are up to a maximum of $2,000 annually per student. The Guardsmen Scholarship Pr ogram currently supports over 180 students in the Bay Area. For the f all of 201 3 , Current recipients of t he Guardsmen Scholarship will be supported through grade 12 ( subject to available fu n ding ) , assuming their famil ies continue to meet our eligibility guidelines and complete an application every year. Do I Qualify? You qualify for tuition assistance if you meet ALL of the following criteria: 1) Your child lives in the Bay Area. 2) Your child will be enterin g grades K - 6 in the f all of 2013 OR has received a s cholarship in the past. 3) Your child maintain s a GPA of at least a 2.0 while receiving scholarship funds. 4) Your child does not also accept a scholarship from Basic Fund, Making Waves, Ind ependent Scholarship Fund, or Vision of Hope. 5) Your child meet s all academic and other admission requirements of the private school to which he/she appl ies. 6) Families must qualify for the federal assisted lunch program (see chart below). This application can NOT be processed unle ss you submit copies of your 201 2 federal income tax returns (Form 1040) or a copy of your AFDC or social security documents. W2 forms and/or pay stubs are not acceptable . Althou gh Foster parents, grandparents, and legal guardians are NOT required to meet the income guidelines, please send AFDC or social security documents. Household Size : includes you, your spouse (if living at same address), and all other family members living at your address for whom you claim financial responsibility on your federal tax form. Income : includes the total gross income of all household members. How Does Tuition Assistance Work? The Guardsmen Scholarshi p is based on the family’s tuition obligation and pays up to a $2,000 per y ear. Scholarship s are awarded for one year . Siblings of scholarship recipients entering grades K - 6 will receive priority for new scholarship s . Should a child accept The Guardsmen scholarship , he/she may NOT receive tuition assistance from BASIC Fund, Independent Scholarship Fund, Making Waves or Vision of Hope. School - based financial aid is acceptable. How Do I Apply? You MUST include appropriate financial documents for the application to be processed. Step One : Refer to the chart to see if your fa mily qualifies financially. Step Two: Fill out the application form. Please send documents : federal income tax returns (Form 1040), CalWorks ( AFDC ) or social security . W2 forms and/or pay stubs are not acceptable. Step Three : If your family qualifies for tuition assistance and your child is awarded a scholarship, you will be notified by mail. The Guardsmen Scholarship Program will then begin paying tuition assistance directly to your school in October and in January . The family will be responsible for paying any tuition costs and fees in excess of the scholarship to the school. Mail application & financial documents to : The Guardsmen Scholarship Program P.O. Box 29250 San Francisco, CA 94129 - 0250 Website: www.guardsmen.org E - m ail: scholarship@guardsmen.org FAX: 415 ) 856 - 0949 Please note the following key requirements: 1. Applications for ALL children must be postmarked no later than April 30 , 201 3 . 2. Applicant recipients will be r equired to provide school attendance and student performance data on an annual basis to remain eligible for the scholarship program . Household Size Annual Income Monthly Income 2 $ 3 5 ,00 2 $2, 917 3 $4 4 , 160 $3, 680 4 $ 5 3,317 $4, 444 5 $ 6 2,475 $ 5,207 Each additional $ 9,158 $ 7 64 C omplete form and fax or mail to : The Guardsmen Scholarship Program P.O. Box 29250 , San Francisco, CA 94129 FAX: ( 415 ) 856 - 0949 Mother’s Name: ______________ __ __________ Father’s Name: ________________ __ ________ Legal Guardian: __________________ __ ______ Street Address: ____________________ __ ____ ______________________ __ __ City/State/Zip: ____ ____________________ __ Email: __________________________ Mother’s Home Phone: (___) _____________ Mother’s Cell Phone (___) _____________ Mother’s Work Phone: (___) _____________ Father’s Home Phone: (___) _____________ Father’s Cell Phone (___) _____________ F ather’s Work Phone: (___) _____________ Guardian’s Home Phone: (___) _____________ Guardian’s Cell Phone: (___) _____________ Guardian’s Work Phone: (___) _____________ Household Size: _______ _ _____ __ # of Parents: _ _ ___ _ __ _ #of Children: _ ___ ____ _ __ Annual Household Income (required): ____ _____ ____ Attach any of the following required documents: 201 2 Federal Tax Return (Form 1040) CalWorks (AFDC) ( 201 2 ) Social Security or Foster Care Benefits Unemployment/Disability or Retirement Benefits – ( 201 2 ) Workers Comp ensation ( 201 2 ) Student Information Student’s Name: ___________________ ____ _____ Date of Birth: _____ / _____ / _____ Gender:  Female  Male Current School: ________________________ Current School is:  Private  Public New School (if known): _______________________ Grade in September 20 1 3 : ______ ___ _ I r eceived The Guardsmen S cholarship in 201 2  Yes  No ======================= Student’s Name: ____________________________ Date of Birth: _____ / _____ / _____ Gender:  Female  Male Current School: ________________________ Current School is:  Private  Public New School (if known): ___________ ____________ Grade in September 20 1 3 : __________ I received The Guardsmen Scholarship in 2012  Yes  No ======================= Student’s Name: ____________________________ Date of Birth: _____ / _____ / _____ Gender:  Female  Male Current School: ________________________ Current School is:  Private  Public New School (if known): _______________________ Grade in September 201 3 : __________ I received The Guardsmen Scholarship in 201 2  Yes  No Add a separate page for additional children P articipation Guidelines Please sign to indicate understanding & agreement.  I certify that the student(s) are Bay Area residents.  I certify that each student will be entering K - 6 in the f all of 2013 or received The Guardsmen Scholarship last year.  I certify that our family is financially eligible, that I have accurately indicated our annual gross household income level, and that I am submitting copies of federal income tax returns, AFDC or social sec urity documents with this application. W2 forms are not acceptable.  I understand that each student must meet all academic and other admissions requirements for the pri vate school to which they apply and that The Guardsmen Scholarship grant is separate fr om the admissions process.  I understand that The Guardsmen Scholarship program grants scholarships based on the families tuition obligation. Scholarships are up to a maximum of $2,000 per year.  I certify that if my child accepts The Guardsmen S cholarship, he/she will not also receive tuition assistance from BASIC Fund, Independent Scholarship Fun d, Making Waves or Vision of Hope.  I understand that scholarships are granted for one school year and each student must re - apply and qualify annually.  If my child receives a scholarship, I hereby permit The Guardsmen to obtain any grades and/or standardized test scores applicable to my child.  I hereby release and indemnify The Guardsmen from any and all claims and liabilities arising out of my children’s participation in this program. DEADLINE : Application must be postmarked no later than April 30 , 201 3 Signature Date 2013 RENEWAL APPLICATION DEADLINE : Postmarked by April 30 , 201 3