Scholarship Grant Application

Scholarship Grant Application

Scholarship Grant Application
Name of Parent/Legal Guardian

First NameLast Name
Name of Student

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number
Student Date of Birth

MonthDayYear
Date
UVA eligibility
Number of years student has completed at Unicorn Village Academy
Anticipated graduation date
YesNo
Family’s annual household gross income (subject to verification):
How many adults and children are in your family household?

Tuition assistance currently received (e.g. McKay, Gardiner, and other scholarships)

Rows	Amount	Source
$
$
$

YesNo
If so, please explain:
Please explain why you are requesting financial aid.
Yes
Should be Empty: