Scholarship Form
Child Name:
*
First Name
Last Name
Date of Birth:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Residential Status:
*
Please Select
Dependent Pass
Permanent Residence
Citizen
Visit Pass
LTVP
Present School:
*
Current Grade:
*
Please Select
Pre-School
Nursery
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Parents details
Father Name:
*
First Name
Last Name
Father's Residential Status:
*
Father's Occupation:
*
Father Phone Number
*
-
Area Code
Phone Number
Father Email:
*
example@example.com
Mother Name:
*
First Name
Last Name
Mother's Residential Status:
*
Mother's Occupation:
*
Mother Phone:
-
Area Code
Phone Number
Mother Email:
example@example.com
Address:
*
Street Address
Street Address Line 2
City
State
Zip Code
Scholarship Applied for:
*
Please Select
DPSIS Merit Scholarship
DPSIS Achievement Scholarship
DPSIS Financial Scholarship
Submit
Should be Empty: