ST. IGNATIUS SCHOLARSHIP APPLICATION

Name of Applicant REQUIRED Please fill out this field. Please enter valid data.

Sex REQUIRED Please fill out this field.

Age REQUIRED Please fill out this field. Please enter valid data.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Social Security Number REQUIRED Please fill out this field. Please enter valid data.

Check All That Apply: Baptized First Communion Confirmed Religious Education Youth Group Altar Server

School Applicant will attend: REQUIRED Please fill out this field. Please enter valid data.

Grade Applicant will enter REQUIRED Please fill out this field. Please enter valid data.

PARENT INFORMATION:

FATHER'S NAME:

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

MOTHERS NAME:

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

ADDRESS REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Check All That Apply: REQUIRED Married Separated or Divorced Single Parent Parent Disabled Parent Deceased Please fill out this field.

Check All That Apply: REQUIRED Registered Member of Parish over 1 year New Member of parish less than 1 year Use envelopes Use checks Use Online Giving Please fill out this field.

Dependents:

List all children residing in the home; indicate ages and schools attending: REQUIRED Please fill out this field.

List all other dependents:

FINANCIAL STATUS:

Income:

Father's Occupation REQUIRED Please fill out this field. Please enter valid data.

Annual Salary REQUIRED Please fill out this field. Please enter valid data.

Mother's Occupation REQUIRED Please fill out this field. Please enter valid data.

Annual Salary REQUIRED Please fill out this field. Please enter valid data.

Dollar Amount of Pension, social security, alimony, etc... Please enter valid data.

Total Income REQUIRED Please fill out this field. Please enter valid data.

Have you applied for any additional tuition assistance/scholarships? REQUIRED Yes No Please fill out this field.

If yes, please list who you have applied with: Please enter valid data.

Residence:

Do you own your home? REQUIRED Yes No Please fill out this field.

Do you have a mortgage? REQUIRED Yes No Please fill out this field.

Amount of Monthly Payment REQUIRED Please fill out this field. Please enter valid data.

Do you have a 2nd mortgage or equity loan? REQUIRED Yes No Please fill out this field.

Monthly Payment Amount REQUIRED Please fill out this field. Please enter valid data.

Do you rent your home? REQUIRED Yes No Please fill out this field.

If yes, amount of rent each month? REQUIRED Please fill out this field. Please enter valid data.

Other Expenses:

Medical (annual): REQUIRED Please fill out this field. Please enter valid data.
Tuition:
Elementary: REQUIRED Please fill out this field. Please enter valid data.
Middle School: REQUIRED Please fill out this field. Please enter valid data.
High School: REQUIRED Please fill out this field. Please enter valid data.
College: REQUIRED Please fill out this field. Please enter valid data.
Day Care: REQUIRED Please fill out this field. Please enter valid data.
Loans: REQUIRED Please fill out this field. Please enter valid data.
This application must be submitted by Monday, March 17, 2025 to be considered.
This application is confidential.
I Understand. Please select this field.