The following information is required to help us determine eligibility for tuition assistance. All information is kept confidential. Scholarships are considered on a rolling basis when funding is available. Scholarship funds are limited. Please fill out all sections of the application. Should you have any questions, please call Christina Bray at 404-872-5338 ext. 236.

The following information is required to help us determine eligibility for tuition assistance. All information is kept confidential. Scholarships are considered on a rolling basis when funding is available. Scholarship funds are limited. Please fill out all sections of the application. Should you have any questions, please call Christina Bray at 404-872-5338 ext. 236. Scholarships may only be applied to class tuition. Students must provide any supplies/materials needed for classes.

Part 1 – Student Information

*Student Name:

*Birth Date:

*Home Address:

*Home/Cell:

*City:

*State:

*Zip:

New Student?:

YesNo

 

*Occupation:

 

*Employer’s Name:

*Work/Cell:

*Work Address:

*Email:

*City:

*State:

*Zip:

 

 

*Please indicate your annual household income. Please include any alimony payment, rental income, etc. Please attach verification of income with your application (most recent tax return and two most recent pay stubs).

$20K or less$20K-$30K$30K-$40K$40K-$50K$50K-$60K$60K-$70K$80K-$100KOver $100K

What was the amount of your total adjusted gross income on your most recent tax returns?

How many people live in your household (that are counted as dependents on your taxes)?

*Please upload Income Verification Document.

 

Part II – Class Information

**Please list the class(es) you would like to take.

Class Title:

Instructor:

Day & Time:

 

Class Title:

Instructor:

Day & Time:

 

Class Title:

Instructor:

Day & Time:

 

 

Part III – Scholarship Information

Have you received scholarship assistance from Callanwolde in the past?

YesNo

If yes, please give the quarter/year and amount of scholarship:

*Use the space below to explain why you believe you should receive scholarship aid. Please include any information regarding financial obligations, etc. that you feel might qualify you for scholarship funds and are not reflected in your information above.

 

Part IV – Signature

*I hereby attest that the information listed above is true and complete.
Applicant's Signature:

Printed Name:

*Date:

 

Part V – Recommendation

*Please attach a letter of recommendation from a personal or professional reference in support of your scholarship application.

The following information is required to help us determine eligibility for scholarship assistance. All information is kept confidential. Please complete all sections of the application. Should you have any questions, please contact Christina Bray, Outreach Director, at cbray@callanwolde.org or (404) 872-5338 ext. 236.

Part 1 – Student Information

*Student Name:

*Birth Date:

*Home Address:

*Home/Cell:

*City:

*State:

*Zip:

*Email:

Parent/Guardian (if Under 18):

Parent/Guardian Phone:

Parent/Guardian Email:

 

 

*Please indicate the type of disability the student has:

AutismHearingCognitive/IntellectualMental Health/EmotionalPhysicalSensoryVisionMultiple DisabilitiesOther (please specify)

 

Part II – Class Information

**Please list the class(es) you would like to take.

Class Title:

Instructor:

Day & Time:

Class Title:

Instructor:

Day & Time:

Class Title:

Instructor:

Day & Time:

 

Part III – Scholarship Information

Have you received scholarship assistance from Callanwolde in the past?

YesNo

If yes, please give the quarter/year and amount of scholarship:

*Use the space below to explain why you believe you should receive scholarship aid. Please include any information regarding financial obligations, etc. that you feel might qualify you for scholarship funds and are not reflected in your information above.

 

Part IV – Signature

*I hereby attest that the information listed above is true and complete.
Applicant's Signature:

Printed Name:

*Date:

 

Part V – Recommendation

*Please attach a letter of recommendation from a personal or professional reference in support of your scholarship application.