2023–2024 SLC Campus Scholarship Application - American Heritage School

How many of you children are applying for scholarships? *

Name of Student 1 *

First

Last

Grade level of Student 1 (2023-2024 School year) *

Name of Student 2 *

First

Last

Grade level of Student 2 (2023-2024 School year) *

Name of Student 3 *

First

Last

Grade level of Student 3 (2023-2024 School year) *

Name of Student 4 *

First

Last

Grade level of Student 4 (2023-2024 School year) *

Name of Student 5 *

First

Last

Grade level of Student 5 (2023-2024 School year) *

Name of Student 6 *

First

Last

Grade level of Student 6 (2023-2024 School year) *

If you have more than 6 students in need of scholarships, please enter the First and Last Name and Grade Level in the box below for any students beyond the six listed above.

Parent/Guardian 1 *

First and last name

Parent/Guardian 2

First and last name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Parent/Guardian 1 Occupation *

Parent/Guardian 2 Occupation

Describe the reason for the request and the family’s current circumstances. *

Upload most recent, signed 1040 form *

Click or drag a file to this area to upload.

Contact our principal, Mr. Leland Anderson (landerson@ahsmail.com) if having trouble uploading, or if you have questions about uploading your 1040 form.

Dependents

Please list all dependents in order of oldest to youngest.

How many dependents do you have? *

Dependent 1 name *

First

Last

Dependent 1 birthdate *

Grade level of dependent 1 *

Name of dependent 1 school *

Dependent 2 name *

First

Last

Dependent 2 birthdate *

Grade level of dependent 2 *

Name of dependent 2 school *

Dependent 3 name *

First

Last

Dependent 3 birthdate *

Grade level of dependent 3 *

Name of dependent 3 school *

Dependent 4 name *

First

Last

Dependent 4 birthdate *

Grade level of dependent 4 *

Name of dependent 4 school *

Dependent 5 name *

First

Last

Dependent 5 birthdate *

Grade level of dependent 5 *

Name of dependent 5 school *

Dependent 6 name *

First

Last

Dependent 6 birthdate *

Grade level of dependent 6 *

Name of dependent 6 school *

If you have more than 6 dependents, please enter the First and Last Name, Birthdate, Grade, and School Name in the box below for any children beyond the six listed above.

Confidential Financial Information

Do you rent or own your home? *

Rent
Own
Other

County assessed value of home $ *

Amount owed on home $ *

Monthly rent amount $ *

Please explain your living conditions and an estimation of monthly living costs. *

Amount in checking and savings $ *

Amount of other investments $ *

Upon careful consideration of your household income, savings, funds available through family sources such as grandparents, and funds such as the Carson Smith Scholarship, what is the TOTAL MONTHLY AMOUNT you can afford to pay for your child(ren) to attend American Heritage School? Please enter a specific dollar amount and a brief rationale. This is not a guarantee of the scholarship amount; it is merely information to help the Scholarship Committee. *