2025 Jaxson Scholar Application

2026 Jaxson Scholar Application
Thank you for your interest in the Jaxson Scholarship! The Jaxson Scholarship helps eligible families pay for academic tuition and services for their child from preschool through higher education and provides leadership programming for the entire family.

The Jaxson William Augustus Swank Foundation (JWAS) is accepting applications for the 2026 Jaxson Scholarship. Children between the ages of 2.5 and 5 years are eligible to apply for the 2026-2027 school year.

Eligibility includes the following:
- The applicant must currently be between the ages of 2.5 to 5-years-old (entering pre-school, pre-k or kindergarten for the 2026-2027 school year).
- The child must show readiness to be in a primary learning environment (can follow directions, accept a gentle no, be potty trained, etc.).
- Families must qualify within our income guidelines of up to 250% above the Federal Poverty Level ($80,375 or below for a family of 4).
- While you do not need to live in St. Joseph County (IN), all Jaxson Scholars are expected to enroll at a local school in the area.
- Jaxson Scholars and JWAS Families are expected to attend at least 75% of our annual leadership programming (8 out of 10 programs) each year.
- Families must be actively engaged in their child’s education and be positive role models in the community.
- Background checks will be run on the parents/guardians of the application finalists.
- I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty may render for refusal of this application.
To be considered for the 2026-2027 school year, applications must be completed by the deadline, Thursday, October 30, 2025. Submitting an application does not guarantee acceptance as a Jaxson Scholar. The JWAS selection committees determine a child's acceptance into our Jaxson Scholarship program. Finalists will participate in a family playdate and possible family interview for the child applying for the scholarship. JWAS will notify the applicants of their application status no later than December 4, 2025. If selected, the applicant and the family must apply to the chosen school and complete the school's financial aid application no later than February 15, 2026 to be formally accepted by the JWAS Foundation as a Jaxson Scholar.

For more information about JWAS and our Jaxson Scholar application process, please contact our Executive Director, Jeanie Shuck, jshuck@jwasfoundation.org.

The mission of the Jaxson William Augustus Swank Foundation is to perpetuate Jaxson's loving memory by nurturing selected individuals educationally, emotionally, and socially from preschool through higher education in achieving their greatest potential while developing strong moral character as future leaders through our Trilogy of Care.
Jaxson Scholar Application Instructions and Document Checklist
INSTRUCTIONS
- Parent(s)/guardian(s) must sign and date the application form. In two-parent households, both parents must sign.
REQUIRED DOCUMENTS

The following documents are required to determine eligibility for the Jaxson Scholarship. Please mail or email COPIES of the following documents. You may also choose to upload documents below.

BIRTH CERTIFICATE
- Submit a copy ONLY for the child who is applying for the scholarship. The birth certificate must be issued from the Department of Health.
OTHER DOCUMENTS
- Please submit applicable documents stated on the "Household Income" section.
- Please submit documentation if a second parent/guardian is not present.
Please note that incomplete applications may delay processing or result in the application not being processed or considered.

Thank you for your interest in the Jaxson Scholarship!

Please submit ALL required documents via mail, email, or upload.

JWAS Foundation
Attn. Jeanie Shuck
3900 Edison Lakes Pkwy Ste 201
Mishawaka, IN 46545

jshuck@jwasfoundation.org
Submit required documents (maximum size per file is 100MB)

Browse Files

Cancelof
Child/Applicant Information
Child's Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*
MM/DD/YYYY
Gender*

Age on Oct. 30, 2025*
Current School*
City of Current School *
Days/Hours Attending Current School*
Ethnicity*
Religious Affiliation*
Primary Language Spoken in the Home*
How did you hear about JWAS Foundation and the Jaxson Scholarship Program?*

Parent/Guardian #1 Information

Information on Both Parents is Required
Parent/Guardian #1*

PrefixFirst NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*

Area CodePhone Number
Email*
example@example.com
Marital Status:

MarriedWidowedSeparatedDivorcedSingle
Education Completed, Years of Completion, and Degrees Earned*
Occupation, Employer, and Start Date*
Has Parent/Guardian #1 ever been convicted of a felony which has not been expunged?*

YesNo
If yes, please explain:
Is there a Second Parent/Guardian?*

YesNo
If there is not a second parent or guardian, please explain below and submit documentation.

Parent/Guardian #2 Information
Parent/Guardian #2

PrefixFirst NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number

Area CodePhone Number
Email
example@example.com
Marital Status:

MarriedWidowedSeparatedDivorcedSingleOther
Education Completed, Years of Completion, and Degrees Earned
Occupation, Employer, and Start Date
Has Parent/Guardian #2 ever been convicted of a felony which has not been expunged?

YesNo
If yes, please explain:

Household Information

This section helps us understand who lives in your home and verifies eligibility. Please list everyone living in your home, including the child applying for the scholarship.

	Full Name (First, Middle, Last)	Relationship to Potential Jaxson Scholar	Sex (M or F)	Birthdate	Marital Status
1
2
3
4
5
6
7
8
9
10

Total number in household: blank*

Household Income

Fill in the amount of each parent or guardian's monthly income for each category below. If not applicable, please list n/a for not applicable. Please provide two months of supporting documentation for ALL sources of income.
Name of Parent/Guardian #1*

Parent/Guardian #1 Sources of Income*

	Dollar Amount	Frequency of Payment	Annual Gross Income
Wages/Salaries (before deductions) Document Needed: Tax Return Signed
Net Income from Self-Employment Document Needed: Tax Return & Schedule C
Public Assistance: TANF/AFDC Document Needed: Statement
Child Support/Alimony Document Needed: Current Order or Printout
Social Security/SSI Benefits (SS Award Ltr is sent to you Nov/Dec of each year, keep for this purpose) Document Needed: SS - Award Ltr SSI - Printout
Unemployment Insurance Document Needed: Online Statement
Workers Comp Document Needed: Statement
Veteran’s Benefits Document Needed: Statement
Military Pay (does not include hostile fire pay) Document Needed: LES Statement

If you have OTHER income, please list the types and amounts below. Please also include the Annual Gross Income for each. Please provide the documentation to show income.
Type, Amount (with frequency) and Total Gross Income
Parent/Guardian #1 Total Annual Gross Income: blanks*
I,Full name*, certify that the information given above is true and complete to the best of my knowledge and that I have not falsified any information. Date
Signature of Parent/Guardian #1*

Clear
Name of Parent/Guardian #2*

Parent/Guardian #2 Sources of Income

	Dollar Amount	Frequency of Payment	Annual Gross Income
Wages/Salaries (before deductions) Document Needed: Tax Return Signed
Net Income from Self-Employment Document Needed: Tax Return & Schedule C
Public Assistance: TANF/AFDC Document Needed: Statement
Child Support/Alimony Document Needed: Current Order or Printout
Social Security/SSI Benefits (SS Award Ltr is sent to you Nov/Dec of each year, keep for this purpose) Document Needed: SS - Award Ltr SSI - Printout
Unemployment Insurance Document Needed: Online Statement
Workers Comp Document Needed: Statement
Veteran’s Benefits Document Needed: Statement
Military Pay (does not include hostile fire pay) Document Needed: LES Statement

Parent/Guardian #2 Total Annual Gross Income: blanks
I, Full name, certify that the information given above is true and complete to the best of my knowledge and that I have not falsified any information. Date
Signature of Parent/Guardian #2

Clear
Are any additional individuals contributing to the household income?*

YesNo
If yes, please list the types and amounts below. Please also include the Annual Gross Income for each. Please provide the documentation to show income.
Type, Amount (with frequency) and Total Gross Income

References

Please provide two non-family member references.
Reference #1*

First NameLast Name
Relationship
Phone Number*

Area CodePhone Number
Length Known*
Reference #2*

First NameLast Name
Relationship
Phone Number*

Area CodePhone Number
Length Known*

Jaxson Scholar and JWAS Parent Cooperative Agreement

We value our ongoing relationships with our JWAS families. Your involvement is key to your child's success. To help the JWAS Foundation cultivate confidence and success in yours, please initial the statements below.
Initial* I understand that if my child becomes a Jaxson Scholar my Jaxson Scholar/family will be expected to participate in leadership development classes, retreats, social activities, etc. with other JWAS families, as well as perform community service as a part of the Jaxson Scholarship.
Initial* I understand that if my child becomes a Jaxson Scholar there will be expectations around my Jaxson Scholar’s attendance, participation, and overall behavior at school. I understand that I am a major contributing factor in my child’s educational success and will actively participate in monthly, quarterly, and annual meetings regarding my child’s education, if needed. I will communicate and seek solutions to any challenges that may arise that could prohibit my child’s educational endeavors.
Initial* I understand that if my child becomes a Jaxson Scholar I will be required to review the scholarship expectations and update our family income status and participation guidelines on an annual basis.
Initial* I hereby declare that the information provided is true and correct. I also understand that any willful dishonesty my render for refusal of this application.
Scholar Applicant Name: full name* Date: MM/DD/YYYY*
Parent/Guardian #1 Name: full name* Date: MM/DD/YYYY*
Signature of Parent/Guardian #1*

Clear
I hereby certify that all information is true and correct to the best of my knowledge. I understand that any false statement may disqualify my child’s Jaxson Scholar application.
Parent/Guardian #2 Name: full name Date: MM/DD/YYYY
Signature of Parent/Guardian #2

Clear
I hereby certify that all information is true and correct to the best of my knowledge. I understand that any false statement may disqualify my child’s Jaxson Scholar application.
Should be Empty:

2026 Jaxson Scholar Application

Jaxson Scholar Application Instructions and Document Checklist

Child/Applicant Information

Parent/Guardian #1 Information

Parent/Guardian #2 Information

Parent/Guardian Perspective

Household Information

Household Income

References

Jaxson Scholar and JWAS Parent Cooperative Agreement