SCHOLARSHIP APPLICATION
Mail completed application to:
Scholarships for Educational Excellence Foundation, Inc.
745 S. Extension
Mesa, AZ 85210
(602) 318-5689
Or copy and paste this application into an email and send to info@seefaz.org
Application School Year: 2010/2011
PART I: Parent/Guardian Information
LAST NAME: ________________________ FIRST NAME: _______________________
ADDRESS: ______________________________________________________________
CITY: ____________________________ STATE: ________ ZIP CODE: _____________
HM PHONE: ____________________ WK: _______________ CELL: _______________
E-MAIL: ________________________________________________________________
PART II: Student Information.
Please list all students applying for scholarships in your household. If more room is needed, please add an additional sheet.
1.
Last Name: ______________________________ First Name: ______________________
Date of Birth: ________________________ Grade (Fall '09): ________________
Name of school you wish to attend: _________________________________________
Address of school: _______________________________________________________
City: ____________________ AZ Zip: ___________ Phone: __________________
2.
Last Name: ______________________________ First Name: ______________________
Date of Birth: ________________________ Grade (Fall '09): ________________
Name of school you wish to attend: _________________________________________
Address of school: _______________________________________________________
City: ____________________ AZ Zip: ___________ Phone: __________________
PART III: For Attendance Scholarships, please write a short statement of need telling why your child needs to attend the specified school. Need does not have to be financial. Statement of Need:
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PART IV: For Financial Need Scholarships, please attach a statement detailing the financial need of the family. You may attach copies of your most recent tax forms or other information detailing circumstances of need.
PART V: Conditions of Eligibility
1. I certify that all of the named students on this application are residents of Arizona and will be attending a K-12 grade for the Application School Year.
2. I understand that scholarship disbursements will continue only as long as my child remains enrolled in a participating school and I stay current on the tuition and fee payments to the school.
3. I understand that each scholarship awarded is a single-year scholarship subject to the availability of donated funds and that a new application must be submitted for scholarships in subsequent years, except that no scholarship will apply to a grade higher than 12th.
4. I agree to all the terms of this scholarship. I understand that all decisions made by the Scholarships for Educational Excellence Foundation ("SEEF") are final and I agree to release SEEF from any liability in its efforts to provide educational scholarships.
5. I understand that SEEF pays only a portion of the total tuition for each student.
6. I declare that the information on this form, to the best of my knowledge, is complete and accurate and that I agree to the Conditions of Eligibility.
PART V: Signature: _______________________________ Date: __________________
