Kleidon Catholic Education Fund
The information provided on this form will be used by the St. Rose Kleidon Catholic Education Committee to select recipients for tuition assistance. It is important that you give complete details below in order for your application to be considered. All tuition assistance will be based on need and funding. You are not guaranteed tuition assistance by submitting this application. Only applications for Catholic Institutions will be accepted.
Students Basic Information
Students Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Date of Birth
*
-
Month
-
Day
Year
If submitting application for your child, enter child's date of birth.
Student's Gender
*
Male
Female
Are you applying for your child?
*
Yes
No
Back
Next
Parent/Guardian Information
Parent/Guardian 1
*
First Name
Last Name
Parent/Guardian 2
First Name
Last Name
Parent/Guardian 1 Phone Number
*
Please enter a valid phone number.
Parent/Guardian 2 Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Back
Next
Catholic Institution Information
Name of school:
*
Yearly Tuition Amount:
*
If entering a Catholic University, please enter high school previously attended:
Major you are considering:
Back
Next
Are you a registered parishioner of St. Rose of Lima?
*
Yes
No
How long have you been a parishioner of St. Rose of Lima?
What is your involvement in St. Rose of Lima? Please describe (ex. volunteer, ministry or organization)
(If you are submitting this application for your child please also include your or your families involvement)
Please describe yourself: (ex. interests, hobbies, extra-curricular activities)
(If you are submitting this application for your child, describe the child you are submitting the application for)
Describe why Catholic education is important to you:
(If you are submitting this application for your child, describe why it is important for you to have your child in Catholic education)
Back
Next
Financial Information
If you are submitting this application for you child, answer the following questions based on family household income.
Estimated Annual Income:
Please enter combined income if applicable
Number of people supported by this income:
How much tuition can you afford per year:
Are you receiving any other financial assistance for tuition:
Yes
No
If Yes, please list other financial assistance or scholarships and amounts:
Submit
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform