Needs-Based Scholarship Application Form

1
Are you an HLA family or do you plan to register with HLA?
YESNO
2
Have you submitted your application/registration for enrollment with HomeLife Academy?* This field is required.If you have not already done so, please visit www.homelifeacademy.com to complete enrollment. We CANNOT process your Scholarship Application if this has not been done. Please select "CHECK" as your method of payment. This will allow your registration to go through without payment.
YESNO
3
Please visit www.homelifeacademy.com to complete enrollment. After completion of enrollment, you may continue with this application.
4
Is this your first year registering with HomeLife Academy?* This field is required.
YESNO
5
Unfortunately, you do not qualify for a Needs Based scholarship. Due to limited funds the Needs-Based Scholarship is only available for families that have been registered with us for at least one (1) school year. You may be eligible for the CARE Scholarship.

CLICK HERE TO APPLY FOR THE CARE SCHOLARSHIP
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Parent/Guardian Name:* This field is required.
First Name
Last Name
7
Address* This field is required.Please enter your FULL address, as it needs to appear on postal mail, INCLUDING the postal code.
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Phone Number* This field is required.
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E-mail Address:* This field is required.
10
Have you received a scholarship from HLA in the past?* This field is required.
YESNO
11
How many total people living in your house?* This field is required.
12
Please enter the total **MONTHLY** income from ALL sources (wages, assistance, benefits, etc).* This field is required.
13
Is the Father/guardian working?* This field is required.
Full Time
Part Time
Receives disability, SS, or other assistance.
There is no Father/guardian.
The Father/guardian receives no income at this time.
14
Is the Mother/guardian working?* This field is required.
Full Time
Part Time
Receives disability, SS, or other assistance.
There is no Mother/guardian.
The Mother/guardian receives no income at this time.
15
Has there been a recent job loss?* This field is required.
YESNO
16
Please explain the job loss circumstances.* This field is required.
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Are any family members dealing with medical issues that have created high medical expenses?* This field is required.
YESNO
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Please explain the financial circumstances with the medical issues.* This field is required.
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In your own words, how would scholarship funds impact or help your family continue to homeschool?* This field is required.
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What specific financial needs do you have? (purchase curriculum, pay registration fees, pay bills, buy groceries, etc)
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Other Comments
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Conditions of Scholarships* This field is required.By clicking "I understand" below, I acknowledge that I can only receive a total of two (2) full scholarships per lifetime and that I cannot receive this scholarship my first year with HLA. I also understand filling out a scholarship application does not guarantee I will receive one. Scholarship funds are limited.
I understand
23
Would you like to make a small donation towards the scholarship fund? This is optional; but any payment, even $10, allows us to give more scholarships to families in need.
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Description
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+ OR enter a custom value
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