ASE Scholarship Application Form

Laurelhurst ASE Class Scholarship Application Form
LASER is committed to making our programs affordable. We realize there may be circumstances where payment of the entire fee is a hardship. We strive to make our programs available to as many children as possible, given our available and limited resources.

This application is for the Laurelhurst ASE classes only.
To assist families in need, we have the following requirements:
1. Families who meet established income qualifications are eligible for up to a 50% scholarship for one (1) ASE class per child.
2. Payment plans are available, and must be worked out in advance of the program with the Executive Director. All payment plans must be approved by the Executive Director and payments must be kept up-to-date.
3. Scholarships are given on the basis of eligibility and the availability of funds. No scholarships are guaranteed. New applications are required for EACH semester of ASE classes for which youare seeking assistance.
Scholarship Application Procedures
1. Fill out and submit a complete application form with all required proof of income attachments. You may submit 1 application for multiple children in your family.
2. Along with your application, provide a complete copy of last year’s tax return (all Schedules) OR the last two months of current employment pay stubs. (Your application cannot be processed without this documentation.)
3. Your application will be reviewed and your finances compared to standard income guidelines.
4. Please allow 14 business days from the date LASER receives your completed application (including documentation of your tax return/income and declination letters from subsidy programs).
5. If approved for an ASE scholarship, a parent will receive 50% off one (1) ASE class per child. A parent will receive a coupon code to be used at registration checkout which will waive 50% off a class fee. Parents should use this code to register for the desired class.
Child(ren) to Apply Scholarship towards
Name of Child *

First NameLast Name
Child's Grade*
Name of Additional Sibling

First NameLast Name
Additional Child's Grade
Name of Additional Sibling

First NameLast Name
Additional Child's Grade
Which ASE session is this scholarship application for?*

Fall SessionWinter/Spring Session
Which class would the scholarship be applied to?
Household Information:
Number of parents or guardians in household*
Parent/Guardian #1 Name:*

First NameLast Name
Parent/Guardian #1 Phone:*
Parent/Guardian #1 Email:*
example@example.com
Parent/Guardian #2 Phone:
Parent/Guardian #2 Email:
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Total annual income for household:*
Important: As proof of income you must provide a complete copy of last year’s tax return (all schedules) or the last two months of current employment pay stubs.
List the names and ages of ALL children (dependents under 18 years of age) in your family:
Child #1 Name*

First NameLast Name
Parent/Guardian #2 Name:*

First NameLast Name
Child #1 Birthdate*

MonthDayYear
Date
Child #2 Name

First NameLast Name
Child #2 Birthdate

MonthDayYear
Date
Child #3 Name

First NameLast Name
Child #3 Birthdate

MonthDayYear
Date
Which, if any, of the following do you currently receive?*

Temporary Assistance to Needy Families (TANF)Free or reduced school lunchesSubsidized HousingFood StampsSocial Security Supplemental Security IncomeDisability Lifeline (Washington State)State Family Assistance (SFA)General AssistanceOther (e.g., unemployment, disability, etc.)None
The following questions are optional. The answers provide a more complete picture of your family so that we may better meet your child care needs.
Parents Marital Status

MarriedUnmarriedDivorcedSeparated
Number of persons employed in the household:
Parent/Guardian #1:
Age
Highest level of education completed
Occupation
Employed?

YesNo
Is there any other information you would like to share regarding your situation?
Parent/Guardian #2:
Age
Highest level of education completed
Occupation
Employed?

YesNo
Required Documentation

The following documentation is required to process your scholarship application. If uploading a digital copy is a burden, you may turn in a paper copy at LASER. However, we will not be able to process your application until all required documentation has been turned in.
Complete copy of last year's tax return (all schedules) OR the last two months of current employment pay stubs.*

Cancelof
Scholarship applications are reviewed upon receipt of this application and all required forms and documents (the “completed application”). You will be notified of a determination within 14 business days from the date LASER receives your completed application. If your income or household size changes, you must promptly report such changes as they occur, as it may affect your eligibility. Scholarships apply ONLY to the fall or spring semester requested. You must reapply for a new scholarship for each session. Applicants are limited to one (1) 50% scholarship per child per session.
I understand a maximum scholarship discount of 50% may be applied to one (1) ASE class per child.*

Yes
I have read the above and verify that all information is true and correct. If a scholarship is granted or pending, I will promptly report to LASER any changes in my financial status.*

Yes
For Office Use Only:
Approved for:

50% of ASE Class in Fall50% of ASE Class in Winter/SpringDenied
Denial Reason
Approved by:
Date

MonthDayYear
Date
Should be Empty:

Laurelhurst ASE Class Scholarship Application Form

Required Documentation