Need-Based Scholarship Application Form

If you would like your children to be considered for a Need-Based Scholarship at the Salt Lake City campus of American Heritage School, please fill out the following form.

Be prepared to upload your most recent tax form 1040 and provide other financial information

How many of you children are applying for scholarships? *

Name of Student 1 *

First

Last

Grade level of Student 1 (2022-2023 School year) *

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 *

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 *

Confidential Financial Information

Do you rent or own your home? *

Rent
Own
Other

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 public funds such as the Carson Smith Scholarship, what is the TOTAL MONTHLY AMOUNT you can afford to pay for your children to attend American Heritage School? Please enter a specific dollar amount and a brief rationale. *