Education Fund Application Form

Education Fund Application Form

Applicant Information

Student Name:

Date of Birth:    Student ID:

Current Grade / Program:    Expected Start Date (term):

Parent / Guardian (if applicant is a minor)

Applicant is 18 or older:

Academic Information

Current GPA:    College / School Name:

Financial Need and Household Information

Funding Request

Amount Requested (USD):    Intended Use (tuition, books, fees):

Supporting Documents Checklist

Official transcript or grade report

Recent financial statement or pay stubs

Cost estimates / invoices for intended expenses

Other supporting documentation (medical bills, letters, etc.)

Certifications, Authorizations, and Terms

By submitting this application I certify under penalty of perjury that the information provided in this application and accompanying documentation is true, complete, and accurate to the best of my knowledge. I understand that any material misstatement or omission may result in denial of funding or recovery of disbursed funds and may subject me to civil or criminal penalties where applicable.

I authorize the Fund administrators, their agents, and my educational institution to verify academic records, enrollment status, and financial information necessary to evaluate this application. I authorize release of such records for the sole purpose of administering this application and any award. I understand that information provided will be used for eligibility determinations and may be audited.

If awarded, funds must be used only for the expenses described in this application unless prior written approval is obtained. I agree to retain receipts and provide documentation of expenditures upon request within the timeframe specified by the fund. Failure to provide required documentation or use funds for unauthorized purposes may result in demand for repayment.

I understand the Fund reserves the right to deny, reduce, suspend, or recover awards for noncompliance, fraud, or other causes as determined by the Fund's governing procedures. I acknowledge that receipt of funds does not create any entitlement to future awards.

Consent for Minor: If the applicant is under 18 years of age, the parent or legal guardian signing below certifies that they are authorized to act on behalf of the minor applicant, accept the terms herein, and to execute any required documentation for release of funds.

I consent to receive communications regarding this application by email or phone and acknowledge it is my responsibility to maintain current contact information with the Fund.

Declarations (Check to Acknowledge)

I certify that the statements in this application are true and complete.

I agree to use funds only for authorized educational expenses and to provide receipts if requested.

I authorize release of academic and financial records for verification.

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