Application Form - Scholarship Grant

Christian Winnings’ Scholars Program Application Form

Application Deadline - February 22, 2017
We're glad you're exploring the Christian Winnings’ Scholars Program for school funding! Each year we award thousands of dollars in scholarships to talented students in the State of Florida.

In order to make this experience a reality for as many students as possible, we are committed to a scholarship program and payment plan options that enable qualified students from all cultural, racial and socio-economic groups to attend. In short, our Scholars Program allows Christian Winnings School to enroll deserving students who may not otherwise have access to an independent school education.

This is a highly competitive program and will require that you take the time to fully and accurately portray yourself. Please do not be discouraged by the number of questions and amount of information requested.

Note: All winners will be notified on or before the 28th of February 2017.
If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.
I. Personal Data:

Please provide information on the program participant.
Full Name*

PrefixFirst NameMiddle NameLast NameSuffix
Social Security Number :*
(e.g. 123456789)
Birthdate:*

MonthDayYear
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Optional Information:

Information regarding gender, ethnic origin and race are optional. The information is requested for post-scholarship report generation only and in no way affects your selection for school scholarship awards. However, providing this information may increase your opportunities for scholarships where donors have asked that priority consideration be given to students meeting certain demographic criteria (such as minority status, parent's place of employment, area of study, etc.)
Gender:

MaleFemale
Are you a US citizen?

YesNo
Ethnic Origin:

HispanicNon-HispanicNot Indicated
Race? (Choose one or more):

WhiteBlack or African AmericanAsianAmerican Indian or Alaskan Native Hawaiian or Other Pacific IslanderNon-Resident Alien
Please check veteran status (Check all that apply)

VeteranChild of a VeteranGrandchild of a VeteranSpouse of a VeteranNone of the Above
Status at the time of application:

K-3 Grade level for SY184-5 Grade level for SY186-8 Grade level for SY189 Grade level for SY1810-12 Grade level for SY18
Have you submitted an application for admission?

YesNo
II. Parent/Guardian Information:
Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
HOUSEHOLD SIZE
Please include all individuals living within your home.
Number ofAdults*

123 or more
Number of Children*

123 or more
TOTAL COMBINED HOUSEHOLD INCOME FOR THIS TAX YEAR. We require that you submit a copy of tax return (please black out social security numbers):*
2016 Tax Return

Upload a File

Cancelof
III. School Information (student only):
Are you or will you be a May 2018 high school graduate?

YesNo
Most recent cumulative GPA:
School activities, community activities, volunteer work, honors, offices held:
IV. For Transfer Students Only:
Most recent school attended and cumulative transfer GPA:
V. For Students Currently Enrolled at Christian Winnings:
Current GPA:
School activities, honors, offices held, etc.:
VI. Extras:
Christian Winnings administers many scholarships designed to offer aid to students that represent unique characteristics. Please check each of the qualifiers below that apply to you. This data may increase your likelihood of qualifying for selected scholarships. Please note, if you are awarded a scholarship based on any of these qualifiers, you will be asked to produce documentation verifying your unique eligibility.
Have you ever received a scholarship at Christian Winnings?

YesNo
Do you plan to transfer to a public school?

YesNo
Do you have a disability?

YesNo
Were you born outside the USA?

YesNo
If so, what country?
Were your parents born outside the USA?

YesNo
If so, what country?
Do you have a relationship with anyone affiliated with Christian Winnings School?

YesNo
If yes, Name and Year of their attendance:
VII. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:*
Christian Winnings School is committed to equal opportunity in employment and education. The School does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

Christian Winnings’ Scholars Program Application Form

I. Personal Data:

II. Parent/Guardian Information:

III. School Information (student only):

IV. For Transfer Students Only:

V. For Students Currently Enrolled at Christian Winnings:

VI. Extras:

VII. Applicant's E-Signature