Join the Waitlist | PSC SGO Administrators

01

Student Information

Enter the applicant student's personal and contact details.

First name *

Last name *

Date of birth

Grade level *

Gender

Home address

Street address

City

State *

ZIP code

Contact information

Phone number

Student email (if applicable)

02

Parent / Guardian

Provide details for the primary parent or legal guardian.

Primary parent / guardian

First name *

Last name *

Relationship

Phone

Email *

Employer (optional)

Second parent / guardian (optional)

First name

Last name

Relationship

Phone

03

Household & Finances

Used for eligibility determination. All information is kept strictly confidential.

Eligibility note: The Education Freedom Tax Credit (IRC § 25F) prioritizes households at or below 300% of the Federal Poverty Level. Participation in qualifying federal or state assistance programs may satisfy income verification requirements.

Number of people in household *

Total annual household income *

Public assistance programs

04

Academic Background

Tell us about the student's current educational setting and activities.

Current school name

Current school type *

Academic standing / GPA

Accepted to requested school already?

YesNo

Extracurricular activities & interests

Special needs & accommodations (confidential)

Does the student have an IEP, 504 Plan, or documented special need?

This information is kept confidential and helps match students to appropriate scholarship resources.

YesNo

05

Scholarship Request

Tell us which qualifying education expenses you need help with, and share your personal statement.

06

Documents & Certification

Confirm which supporting documents you will submit, then sign the application.

Check each document you are enclosing. Missing documents may delay review and disbursement.

Supporting documents

Proof of household income (1040, W-2s, or verification letter)Student birth certificate or government IDProof of current enrollment / transcriptIEP / 504 Plan (if applicable)

Signature & certification

Full legal name

Relationship to student

Date

I certify that I am the parent or legal guardian of the student named in this application (or the student if age 18 or older), and that I am authorized to submit this application on the student's behalf.I certify that all information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that providing false or misleading information may result in disqualification and recovery of any scholarship funds disbursed.

Fields marked * are required. Once submitted, you will receive a confirmation — save it for your records.