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This Month's Series
Memory Verse Songs
Leading at Home
4:12 Youth - Jr. High
4:12 Youth - Sr. High
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Kiddie Kampus Preschool
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Information Form
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Financial Aid
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Financial Aid Application
Kiddie Kampus Financial Aid Application
Please fill out the information completely.
Fields marked with a
*
are required.
Session
*
Session I (8:30 - 11:00 AM)
Session II (12:00 - 2:30 PM)
Child's Name
*
First
Last
Birthdate (MM/DD/YYYY)
*
Social Security Number
*
Gender
*
Male
Female
Child's Home Address
*
Line 1
Line 2
City
State
Zip Code
Country
Household Size (Include parents, stepparents, guardians, grandparents, and ALL children)
*
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Please list all individuals in the household INCLUDING relationship to child and age.
*
Parent/Guardian #1 Name
*
First
Last
Phone Number
*
Address (If different than child's)
*
Line 1
Line 2
City
State
Zip Code
Country
Employer
*
Position
*
Length of employment
*
Hours per week
*
Hourly rate/salary
*
If no employer, please state reasons below:
*
Parent/Guardian #2 Name
*
First
Last
Phone Number
*
Address (if different than child's)
*
Line 1
Line 2
City
State
Zip Code
Country
Employer
*
Position
*
Length of employment
*
Hours per week
*
Hourly rate/salary
*
If no employer, please state reason:
*
Please state the reasoning for applying for a Scholarship:
*
Please describe unusual circumstances that would affect your annual expenses and otherwise need to apply for scholarship:
*
How much, per month, can you contribute toward tuition:
*
How are you willing to work toward paying for your child's tuition? (i.e. volunteering time at Kiddie Kampus, organizing fundraisers, preparing materials for teachers)
*
Upload scanned copy of U.S. Tax Return Form (1040)
*
Max file size: 20MB
Adjusted gross income for 2016
*
Please checkmark (✓) other sources of income for ANYONE living within your household:
*
Child Support
Welfare
Social Security
Disability
Food Stamps
WIC (Women, Infants, Children)
Section 8 Housing
Unemployment Compensation
Other
Upload scanned proof of additional income source(s):
*
Max file size: 20MB
Upload scanned proof of additional income source(s):
*
Max file size: 20MB
List individual(s) receiving income, type of income, and annual amount:
*
I hereby certify that all information in this application is true and correct. In addition,
I understand that Kiddie Kampus Preschool may verify the information on this application. I also agree to participate in my child's education, school functions and work to help pay off some of my child's tuition if granted with a financial need money.
Person filling out application:
*
Child's Mother
Child's Father
Other (Please describe)
Other (please describe)
*
Name
*
First
Last
Submit
✕
