Application for Boothbay Region Student Aid Fund Grant

Application for BRSAF Grant

Please fill the fields below with your information
ALL DOCUMENTS MUST BE SUBMITTED BY THE FOLLOWING DATES TO BE CONSIDERED FOR A GRANT:
- MAY 1 FOR BRHS SENIORS
- AUGUST 1 FOR UPPERCLASSMEN, GRADUATE LEVEL AND NON-TRADITIONAL APPLICANTS
School year for which you are applying for a grant (eg 2022-2023)
Name

First Name Middle Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email Address *
Phone Number

Area Code Phone Number
Date of birth
Parent/Guardian Contact Information (if different)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent's email
example@example.com
Year of graduation from BRHS
Name of Institution you will be attending
Address of Financial Aid Office

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number of Financial Aid Office

Area Code Phone Number
Enrolling as a

1st year 2nd year 3rd year 4th year Graduate School Certificate Professional Trade Vocational License
What is the name of the program, or major that you are enrolled in?
What is your student ID#?
Will you be a part-time student?

Yes No
If you will be living at home, how many miles will you commute each week to attend class?
If you are related to a member of American Legion Post #36 or Lion's Club, please provide their name and relationship.
Are you a Veteran?

Yes No
I agree to let my name be used in correpondence with the Named Fund donors in the event that I receive a grant supported by a Named Fund.

I understand that all required documents as outlined below must be submitted for my application to be complete.
Signature

Clear
Upload supporting documents here; FAFSA/SAR, Financial Release Form, Award statement or billing statement (must include COA and grants/scholarships from school).

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Application for BRSAF Grant