IDOE Choice Scholarship Application (Choice Voucher)

Student Info, cont.
Student(s) Home Address:*

Street Address

Apt #, etc. (if applicable)

CityState / Province

Postal / Zip Code
Is this the same address as your choice scholarship last year?*

YesNo, we've movedNot applicable, we're a new family to CCS

Special Education
List any student(s) that have an Individualized Education Program (IEP) / Service plan:

Household Size and Income
Questions? Refer to the following forms regarding household size and income:
Household Size:*
Adjusted Gross Income (AGI) from 2023 Federal Tax Return:*
Does your 1040 Tax Form provide a complete and accurate picture of your household size AND income?*

YesNo, we have multiple 1040's or additional dependents not included on the 1040

Household Size and Income, cont.
DISCLAIMER: While we've taken numerous measures to protect your data (encrypted form, password-protected dropbox, etc.), we cannot guarantee absolute security. If you would prefer to drop off your tax form in person, select that option below.
Upload your 1040 Tax Return (only page 1 required):

Cancelof
Alternative submission:

I prefer to drop off my 1040 Tax Return to the school office in person.

Household Size and Income, cont.
DISCLAIMER: While we've taken numerous measures to protect your data (encrypted form, password-protected dropbox, etc.), we cannot guarantee absolute security. If you would prefer to drop off your tax form in person, select that option below.
Upload your first 1040 Tax Return (only page 1 required):

Cancelof
(If applicable) Upload your second 1040 Tax Return (only page 1 required):

Cancelof
(If applicable) Upload your third 1040 Tax Return (only page 1 required):

Cancelof
Alternative submission:

I prefer to drop off my 1040 Tax Returns to the school office in person.
HOUSEHOLD SUMMARY FORM:

CLICK HERE to download and complete the Household Summary Form (only page 3 required). This is a state requirement for families in which all household size/income is not included on a single 1040 tax form.
Upload your completed Household Summary Form (only page 3 required):

Cancelof
Alternative submission:

I prefer to drop off my Household Summary Form to the school office in person.

Verification
I have reviewed all the requirements to determine household size and household income in its entirety and with my signature I verify that I have accurately disclosed this information to determine my student's eligibility for the Choice Scholarship Program.*

Clear
Should be Empty:

Student Info