SPATIL Scholarship Form

SPATIL Scholarship Application Form

Application Deadline -December 18, 2019
Read and follow the instructions carefully prior to submitting your application. (Include link to instructions here). All awardees will be notified 3 weeks prior to entry date.
Read and Understand the instructions.*

Yes, I have
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. Parent / Guardian Personal Data:

Tell us about yourself
Parent / Guardian Full Name*

First NameLast Name
Student Full Name*

First NameLast Name
Student Birthdate:*

MonthDayYear
Mobile No. :*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Home Address ( if different from Parent/Guardian) :

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
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 this scholarship award. 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 income, special educational needs etc.).
Gender:

MaleFemale
Are you a US citizen?

YesNo
Ethnicity? (Choose one or more):

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

Child of a veteranGrandchild of a veteranNone of the above
What grade is the student in?
What is the reason you are applying for our scholarship?

0/300
Have you submitted an application for admission?

YesNo
II. Current School Information:
What school will you be attending or currently attending?
2018-19 Students are eligible for consideration for any summer scholarships (if offered) in addition to fall-spring awards for the following school term. Accepting a summer award does not require you to attend in the following school year.
Would you like to be considered for a summer award?

YesNo
(Parent /Guardian) please list any community activities or volunteer work:
III. Mandatory Testing Information:
Has your student taken any Standardized Tests ? If so, which test(s) :
Score?
Standardized testing scores are not required for scholarship eligibility. However, providing any testing score can increase the likelihood of your selection.
V. Students Currently Enrolled at (SPATIL) :
Current Grade:
Is your student currently enrolled in SPATIL's After School, Tutoring, and/or Summer Program (please specify)?
VI. Extras:
SPATIL 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.
Has anyone in your household been a previous scholarship recipient of SPATIL ?

YesNo
Do you plan to keep your child at their current school until the end of the school term?

YesNo
Do you plan to transfer your child if Scholarship is awarded ?

YesNo
Is your child involved in any extra curricular activities after school ?

YesNo
Has your child been diagnosed with any disability? (Any disability will not affect scholarship consideration)

YesNo
If yes, please explain.
Has your child ever received a scholarship/voucher for educational purposes?

YesNo
Do you reside, or have you ever resided, in Fayetteville, GA?

YesNo
Are you interested in volunteering for any of SPATIL activities, fundraisers, and/or in-school activities?

YesNo
Are you (parent/guardian) a US citizen?

YesNo
Are you interested in enrolling your child in our after school program as well ?

YesNo
If not, in what country are you a citizen?
Is the student a US citizen?

YesNo
If not, in what country was he/she born in?
Do you have a relationship with anyone affiliated with SPATIL Private Academy ?

YesNo
If yes, please explain:
Eligibility & Requirements
All applicants must be enrolled in elementary school grades K-6 and meet at least 3 of the 4 criteria below:

o Student must maintain an A or B average at their current or previous school

o    No more than three (3) unexcused absences

o    Must provide at least one (1) teacher recommendation

o Scholarship financial eligibility required

Required Documents

All applicants must submit the following documentation for consideration and eligibility.

o    Completed application

o    Teacher recommendation

o Report cards for full previous academic year

o Signed Media Release Form

o    Submit a photo of student

**Recipient is responsible for enrollment fee, book fee, After School Program and uniforms**
VII. Statement of Scholarship Consideration
Statement of why you should be considered for this scholarship:

0/500
VIII. 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:*
SPATIL Private Academy Scholarship Application

SPATIL's Education Foundation
SPATIL Private Academy is committed to equal opportunity in employment and education. The Academy 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:

SPATIL Scholarship Application Form

I. Parent / Guardian Personal Data:

II. Current School Information:

III. Mandatory Testing Information:

V. Students Currently Enrolled at (SPATIL) :

VI. Extras:

Eligibility & Requirements

VII. Statement of Scholarship Consideration

VIII. Applicant's E-Signature

SPATIL Private Academy Scholarship Application