Print and Complete

S.O.U.L Academy “Students of Unlimited Learning”

Admin Office Only:
 
Application No#____________________
 
Date__________________________ 
 
Scholarship Assistance Request (SAR)
 
School Year Applying for: _________________
 
Parent(s)/Guardian information:
 
Primary Name:______________________________________________________________________________
 
Social Security Number _________-_______-___________ Email ____________________________________
 
Home phone (______)_________________________ Cell Phone (_______)______________________________
 
Home Address _______________________________ City __________________ State FL Zip ______________
 
Employer __________________________________________________ Yearly Income: $__________________
 
Weekly $_____________________ Bi-weekly ___________________ Monthly $__________________________
 
SSI Disability $_____________________________________ Child Support $ ____________________________
 
Secondary Name: ____________________________________________________________________________
 
Social Security Number _________-_______-___________ Email _____________________________________
 
Home Phone (_____)___________________________          Cell Phone (_______)_______________________
 
Employer __________________________________________________      Yearly Income: $______________
 
Weekly $_____________________ Bi-weekly ___________________ Monthly $___________________
 
SSI Disability $_____________________________________ Child Support $ _________________________
 
Income: please supply a month of paystubs with consecutive dates. SSI please supply award letter for every member of household that receives benefits. SNAP/TANF – please supply benefit letter. Child Support please supply benefit letter with amounts if you choose to add this income. Please send child/children birth certificates.
 
Scholarship Student:
Student Name __________________________________________________________________________________
 
Male ______        Female ______         Student’s Social Security Number __________- ________-___________
 
Applying for Grade _______ Date of Birth ______/_____/______
 
Previous school attended _________________________________________________________________________
 
Has student been in Foster Care? ________________
 
Student’s Race/Nationality: African American _____ Hispanic ______ White ______ Haitian ______ Other______ 
 
 

 

Scholarship Student:
Student Name __________________________________________________________________________________
 
Male ______        Female ______         Student’s Social Security Number __________- ________-___________
 
Applying for Grade _______ Date of Birth ______/_____/______
 
Previous school attended _________________________________________________________________________
 
Has student been in Foster Care? ________________
 
Student’s Race/Nationality: African American _____ Hispanic ______ White ______ Haitian ______ Other______
 
Scholarship Student:
Student Name __________________________________________________________________________________
 
Male ______        Female ______         Student’s Social Security Number __________- ________-___________
 
Applying for Grade _______ Date of Birth ______/_____/______
 
Previous school attended _________________________________________________________________________
 
Has student been in Foster Care? ________________
 
Student’s Race/Nationality: African American _____ Hispanic ______ White ______ Haitian ______ Other______ 
 
Scholarship Student:
Student Name __________________________________________________________________________________
 
Male ______        Female ______         Student’s Social Security Number __________- ________-___________
 
Applying for Grade _______ Date of Birth ______/_____/______
 
Previous school attended _________________________________________________________________________
 
Has student been in Foster Care? ________________
 
Student’s Race/Nationality: African American _____ Hispanic ______ White ______ Haitian ______ Other______ 
 
My signature is my request for help in applying for this scholarship for my children:
 
Primary Parent Signature __________________________________________
 
Secondary Parent Signature ________________________________________
 
 
S.O.U.L. Academy admits students of any race, color and national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the Academy. It does not discriminate on the basis of race, color, disability, national or ethnic origin in administration of its educational policies, admissions policies and other school-administered programs.