Monarch Scholarship Application

Monarch Scholarship Application

Please fill out all fields to be eligible for consideration of the Azalea City Montessori Monarch Scholarship. The Monarch Scholarship can be up to, but not exceed 20% of full time tuition. Part time programs are not eligible for the Monarch scholarship. Monarch Scholarship's are limited each year and scholarship decisions will be made on or before June 3rd by 5:00 pm Central Time.
Scholarship deadline: Friday, May 14th 2021.

Scholarships will be accepted until May 14th at 5:00 pm. All information must be submitted, including proof of income, on or before 5:00 pm (Central Time) on May 14th, 2021. Late or incomplete scholarship applications will not be considered.
Student's Name *

First Name Last Name
Student's Date of Birth *

Month Day Year
Date
Child's Classroom for the 2021-2022 school year. *
Parent/Guardian Address (Please provide the primary address of the student, in the case of split custody. ) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian's #1 Name *

First Name Last Name
Parent/Guardian #2 Name

First Name Last Name
Parent/Guardian #1 Email *
example@example.com
Parent/Guardian #2 Email
example@example.com
Parent/Guardian #1 Phone Number *
Please enter a valid phone number.
Parent/Guardian #1 Employer *
Parent/Guardian #1 Position Held *
Parent/Guardian #1 Employer Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian #1 Employer Phone Number *
Please enter a valid phone number.
Parent/Guardian #2 Employer
Parent/Guardian #2 Position Held
Parent/Guardian #2 Employer Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent/Guardian #2 Employer Phone Number
Please enter a valid phone number.
Are you paying for more than one private school's tuition? *

Yes, two different private schools Yes, More than two private schools No, only Azalea City Montessori
Current Monthly Income Chart *
Parent/Guardian Total Combined Household Income per month from the income chart above. *
Please provide proof of income. A copy of page one of last years W-2 returns is required for proof of income. Other documents may be need such as proof of current child support payments, current unemployment forms, current government assistance forms, or current social security/disability forms. *

Cancel of
How many children in your custody will be attending Azalea City Montessori in 2021-2022? *
I   First Name*   Last Name*  , certify that the above information is true and complete to the best of my knowledge. I   First Name*   Last Name* , agree to inform Azalea City Montessori immediately of any changes in income. I   First Name*   Last Name*   , understand that any false or incomplete information could jeopardize my financial assistance and that I must apply again every year.
Signature*   Date*
Should be Empty:

Monarch Scholarship Application

Scholarship deadline: Friday, May 14th 2021.