Scholarship Application

Complete the application form below, then send a copy of your most recent paycheck stub or W-2 to admin@oyespresents.org for income verification.

OYES Scholarship Application

To be filled out by parent, guardian, or applicant over the age of 18 who declares themselves financially independent.

Parent/Guardian/Independent Applicant Full Name

First Name

Last Name

Daytime Phone Number

(###)

###

####

Home Phone Number

(###)

###

####

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Student 1

Full Name (Student 1)

First Name

Last Name

Date of Birth

YYYY

Which program is your child participating in?

Tuition Cost

Student 2

Full Name (Student 2)

First Name

Last Name

Date of Birth

YYYY

Which program is your child participating in?

Tuition Cost (Student 2)

INCOME

Do you receive government aid?

(i.e. Welfare, Medi-Cal, SDI, AFDC, SSI, or SSA)

How many family members live in your household?

What is your total household annual income?

Where are you employed?

Are you a single parent?

If YES, do you receive Child Support?

If YES, how much per month?

Have you ever received a scholarship from OYES before?

If YES, when did you receive the scholarship and for how much?

Type of income verification attached and any notes:

Please provide a statement describing your need for financial assistance.

I certify that the information on this form is true and correct.

STUDENT QUESTIONAIRE

To be filled out by the student.

Student 1

Student 1: In your own words, please share with us why this program is important to you and what you hope to gain from the experience.

Please list TWO teachers (past or present) who are able to serve as references.

Include NAME, JOB TITLE, and PHONE NUMBER

Student 2

Student 2: In your own words, please share with us why this program is important to you and what you hope to gain from the experience. (Student 2)

Please list TWO teachers (past or present) who are able to serve as references.

Include NAME, JOB TITLE, and PHONE NUMBER