EdChoice Request Form 2024-2025

EdChoice Scholarship Program Request Form 2024-2025

For students who are new to the scholarship program
STUDENT INFORMATION

***STUDENT DATA MUST MATCH THE BIRTH CERTIFICATE***
STUDENT FIRST NAME*
STUDENT MIDDLE NAME*
If no middle name please type NONE
STUDENT LAST NAME*
STUDENT DATE OF BIRTH*

MonthDayYear
STUDENT LAST FOUR DIGITS OF SSN*
GENDER*

MALE
MOTHER'S MAIDEN NAME*
STUDENT NATIVE LANGUAGE*
STUDENT ETHNICITY*
STUDENT CITY OF BIRTH*
GRADE LEVEL STUDENT WAS IN ON JANUARY 1, 2024*
GRADE LEVEL FOR 2024-2025 SCHOOL YEAR*
IS THE STUDENT AN INCOMING KINDERGARTENER?*

NO
IS THE STUDENT AN INCOMING HIGH SCHOOLER?*

YES
HAS THE STUDENT EVER ATTENDED ANY OHIO PUBLIC SCHOOL?*

YESNO
IF YES, WHERE?

DISCTRICTBUILDINGYEAR

PRIMARY PARENT/GUARDIAN INFORMATION

RESPONSIBLE FOR THIS FORM AND DOCUMENTATION AND SIGNING SCHOLARSHIP CHECKS.
I AM THE (CHOOSE ONE)*

Natural ParentResidential ParentAdoptive ParentStudent who is at least eighteen years of ageLegal Guardian of student applying for scholarship funds court documents or Affidavit of Eligibility
FIRST NAME*
MIDDLE NAME*
If no middle name please type NONE
LAST NAME*
DATE OF BIRTH*

MonthDayYear
LAST FOUR DIGITS OF SSN*
PHYSICAL ADDRESS*
CITY*
STATE*
ZIP CODE*
COUNTY*
PHONE NUMBER*
EMAIL ADDRESS*
example@example.com
RELATIONSHIP TO STUDENT*

SECONDARY PARENT/GUARDIAN INFORMATION

NO STEP-PARENTS UNLESS THEY HAVE CUSTODY OR GARDIANSHIP. MUST PROVIDE AND UPLOAD DOCUMENTATION.
FIRST NAME*
If no Secondary Parent please type N/A
MIDDLE NAME*
If no middle name please type NONE
LAST NAME*
If no Secondary Parent please type N/A
DATE OF BIRTH*

MonthDayYear
If no Secondary Parent please type N/A
LAST FOUR DIGITS OF SSN*
If no Secondary Parent please type N/A
PHYSICAL ADDRESS*
If no Secondary Parent please type N/A
CITY*
If no Secondary Parent please type N/A
STATE*
If no Secondary Parent please type N/A
ZIP CODE*
If no Secondary Parent please type N/A
COUNTY*
If no Secondary Parent please type N/A
PHONE NUMBER*
If no Secondary Parent please type N/A
EMAIL ADDRESS*
example@example.com If no Secondary Parent please type N/A
RELATIONSHIP TO STUDENT*
If no Secondary Parent please type N/A

SCHOOL INFORMATION
MY STUDENT IS CURRENTLY (CHOOSE ONE ONLY):*

ATTENDING A PUBLIC SCHOOLATTENDING A PRIVATE SCHOOLNEW TO OHIOATTENDING A CHARTER/COMMUNITY SCHOOLHOMESCHOOLED (NEVER ATTENDING AN OHIO SCHOOL)Other
NAME OF SCHOOL THE STUDENT IS CURRENTLY ATTENDING:*
WHAT PUBLIC SCHOOL DISTRICT DO YOU LIVE IN?*
NAME OF PUBLIC SCHOOL YOUR CHILD WOULD ATTEND FOR THE 2024-2025 SCHOOL YEAR:*
***ATTENTION: Income verification is required for New Expansion Scholarship applicants. Income verification is not required to apply for a Traditional EdChoice Scholarship. Families may qualify for low-income status if they choose to have their income verified for the Traditional EdChoice Scholarship. To complete the Income Verification process, parents may submit online using the secure Income Verification system or complete and mail the paper form. Emailing documents is not permitted.

***Proof of residency is required of all first year applicants and must be submitted to the school with the application.***

Parents/Guardians must document residency by providing the school with a current (less than 90 days old) utility bill. The utility (electric, gas, water, sewer, cable/internet) bill must show matching service address and mailing address in the name of the parent/guardian. Post office boxes (except in rural areas where residents only have a PO Box) and cell phone bills have no service address and therefore are not accepted.

Other Acceptable Documents: A monthly mortgage statement (less than 90 days old) or lease/rental agreement (signed by lessee and lessor) and a piece of current business mail (examples: pay stub, bank statement, insurance statement, car payment statement, etc with parent/guardian’s name and address. ***Additional information can be found on the scholarship webpage.***
2024-2025 EDCHOICE PARENT AGREEMENT
PRIVATE SCHOOL NAME (TYPE ST. CHARLES PREPARATORY)*
I AGREE TO THE FOLLOWING:
- The information provided in this application is true and correct.
- I have supplied the chartered nonpublic school with a certified copy of the student’s birth certificate, copies of all custody/guardianship documentation for the student, and proof of my address.
- I have submitted only one EdChoice application for this student.
- The scholarship amount shall only be applied to the tuition of the enrolling school, and I may be required to pay other fees and costs as prescribed by the policies of the school.
- I will sign all scholarship checks received by the private school for my student in a timely manner. I understand that if I fail to endorse the scholarship checks to the school, I will be responsible for paying the student’s tuition.
- If I transfer my scholarship to another participating chartered nonpublic school, I will notify the school of my intent to withdraw and I will return to the original school to sign any remaining checks.
- I will apply for any and all financial aid or tuition discounts and adjustments made regularly available to the students attending the school in which the student is accepted for enrollment.
- I will abide by the Ohio Department of Education (ODE) dispute resolution process outlined in Ohio Administrative Code Section 3301-11 14.
- If I am not a low-income parent or did not complete the income verification process, I will be responsible for paying any difference between the scholarship amount and the tuition of the chartered nonpublic school.
- I must inform ODE and the chartered nonpublic school of any change in the student’s residential address or custody status.
- I will not be able to renew my child’s scholarship if: 1) my family moves to another public school district unless my child would be assigned to an EdChoice designated public school in the new district (applicable only to students who were initially awarded a scholarship based on an EdChoice designated building); 2) my child does not complete all required assessments; 3) my child has more than 20 unexcused absences for the school year; or 4) I fail to complete the renewal process. If my child received an EdChoice Expansion scholarship, I must maintain Ohio residency.
- I have received and understand the policy handbook of the chartered nonpublic school and will abide by its provisions.
- I understand that if my child’s scholarship has been awarded in error, it will be terminated immediately, and I would then be responsible for paying the tuition if I decide to keep my child at the private school.
I designate St. Charles Preparatory School to submit an application on my behalf for the Scholarship Program through the Ohio Department of Education’s electronic application system. By signing below, I agree to the above statements.*

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Today's Date*
Upload a copy of the student's birth certificate here.*

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Upload a Utility Bill here. Please make sure to include all pages of utility bills to show both the service address and the billing address.*

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Upload Custody Documents/Court Documents here. Only upload if you are a Father soley resposonsible for the student's education or a single father.

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Questions/Concerns

Please contact: The SC Finance Office at edchoice@scprep.org
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EdChoice Scholarship Program Request Form 2024-2025

STUDENT INFORMATION

PRIMARY PARENT/GUARDIAN INFORMATION

SECONDARY PARENT/GUARDIAN INFORMATION

SCHOOL INFORMATION

2024-2025 EDCHOICE PARENT AGREEMENT

Questions/Concerns