Jack and Jill Preschool
230 Iron Street
Lehighton, PA 18235
610-377-6562
Email: .
Website: JackandJillLehighton.org
2014-2015 Preschool Term Hagenbuch Scholarship Application General Information
Full tuition for the 2014-2015 pre-kindergarten preschool term at Jack and Jill Preschool is $980. Hagenbuch scholarships are awarded only to children who have already been registered for a pre-kindergarten class for the upcoming term. (Note: the term registered is defined as registration form being completed and returned along with the $40 or $50 non-refundable registration fee to Jack and Jill Preschool). The minimum amount of tuition that a family must pay for their child to attend Jack and Jill is $50; this is considered a “good faith” investment in their child’s preschool education. Scholarship amounts are based on a sliding scale from that $50 investment point.
Scholarships are awarded based on financial need, social need, and spiritual need. Scholarship decisions are made by the Hagenbuch Scholarship Committee which may be made up of members of the Jack and Jill Preschool Board, along with other committee members who are chosen because of their ability to contribute their expertise to the committee.
This committee meets every spring to review any scholarship requests. They may meet at additional times during the year if the need arises. It is the Scholarship Committee’s discretion to decide the amount of money to be given to any family who applies for a scholarship. The funds available for a scholarship during any term vary and are based on any interest accrued from the Hagenbuch Scholarship Account at Trinity Evangelical Lutheran Church. As such, the amount of money available toward any years’ scholarship will vary. This amount may or may not be equal to the amount requested by a family. The decisions of this committee are final.
Due to the age of the children who receive the scholarship(s), the names, addresses, and other personal information are kept private and confidential from the rest of the Jack and Jill Preschool Board and from the general public.
Scholarship applications must be returned to Jack and Jill Preschool Director before June30, 2013 in order to be considered by the scholarship committee for a full term scholarship. The application must be complete and include all requested information in order to be considered by the committee. If there are no scholarship requests, the monies available will stay in the Hagenbuch Scholarship Account until they are needed.
Submission of a scholarship application implies that the family agrees to the conditions listed above.
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Jack and Jill Preschool
230 Iron Street
Lehighton, PA 19235
610-377-6562
Email:
Hagenbuch Scholarship Application for Jack and Jill Preschool, 2014-2015 term
This application and all requested information must be complete and returned to the preschool by June 30, 2014in order to be considered for a full term scholarship by the Scholarship Committee. Applications may be accepted after the July 31st due date in the event of special circumstances. The decision to accept applications after the due date is the Hagenbuch Scholarship Committee’s to make.
Failure to provide any and all requested information will make the scholarship application invalid.
Child’s information:
Child’s name:
Child’s date of birth:
Child’s primary address:
Phone number at address where child primarily resides:
Has the child been registered for a class at Jack and Jill Preschool for the 2014-2015 term?
Which class?
Maternal information:
Mother’s name:
Mother’s address:
Is this a house or apartment:
Do you rent or own this dwelling:
How long have you been living at this address:
Mother’s phone number (home):
Mother’s phone number (cell):
Mother’s email address:
Mother’s employer(s):
Job titles:
Employer’s address(es):
Employer’s phone number(s):
How long have you been employed at this (these) business(es):
I have enclosed copy(s) of all 2013 W-2 form (s) :
Paternal information:
Father’s name:
Father’s address:
Is this a house or apartment:
Do you rent or own this dwelling:
How long have you been living at this address:
Father’s phone number (home):
Father’s phone number (cell):
Father’s email address:
Father’s employer(s):
Job titles:
Employer’s address(es):
Employer’s phone number(s):
How long have you been employed at this (these) business(es):
I have enclosed copy(s) of all 2012 W-2 form(s):
Home information:
With whom does this child primarily reside:
If custody is split, define the days/week or month/year or holidays that the child spends with each parent:
List all others who live at the child’s primary address, include their names, ages and relationship to the child:
If the child also lives with the other parent at a separate address, list all others who live at that address when the child is there:
Social information:
List all activities that the child takes part, i.e. Sunday school (name church), dance class, soccer, gymnastics, T-ball, etc.:
Educational support:
List all educational support services that this child may receive, i.e. physical therapy, speech therapy, occupational therapy, etc.:
List the reasons why the child is receiving these support services:
Personal information:
List any and all forms of income, support, federal aid, S.S.I., welfare, food stamps, housing, medical assistance, etc. that this child receives, or that your household receives on behalf of the child:
List any extraordinary expenses, burdens, etc. that your family is facing that cause financial, emotional, or social distress and would make paying full tuition to Jack and Jill Preschool difficult for the parents of this child:
Amount of scholarship funds that you are requesting on behalf of this child: NOTE-any scholarship family must pay a minimum “good faith” tuition amount of $50 for the preschool term. This “good faith” tuition may be paid in $5/month installments following the ten month tuition installment plan; in $25/semester installments due in August, 2014 & January, 2015; or in full, due August 27, 2014.
The remainder of the tuition for the 2014-2015 pre-kindergarten term at Jack and Jill Preschool is $930. Amounts of money available for a Hagenbuch Scholarship vary from term to term and are based of the interest accrued in the performance of the Hagenbuch Scholarship account investments. The Hagenbuch Scholarship committee can decide to award some or all of the funds available in a preschool term to one individual child, several children or none dependent upon the needs listed on the application.
Please list the amount (if available from the Hagenbuch Scholarship account) that you would like to receive on behalf of this child:
Note that the final decision regarding the final amount of scholarship money that is given to any and all applicants is the decision of the Hagenbuch Scholarship Committee. The decisions of the Hagenbuch Scholarship Committee are final.
Attach a letter addressed to the members of the Hagenbuch Scholarship Committee that outlines your request for a scholarship for the 2013-2014 preschool term for your child.
Include a copy of all parents’ 2013 income tax return, W-2 forms and all other attachments. (the scholarship request will NOT be considered without any and all necessary income verification documents).
I promise that all of the information that I have included in this document is true. Further, if any information is found to be false, it will invalidate this application and I will be responsible for reimbursing Jack and Jill Preschool for any and all scholarship monies that have been allocated for the child listed in this document from the start of the preschool term to the date that they may be withdrawn.
In addition; if the information listed in this document is found to be false, I will also be responsible for any and all full tuition installment amounts that would have been due for this child from the first installment due date (August 27, 2014) to the date that this child is withdrawn from Jack and Jill Preschool.
Signed:
Relationship to the child listed in this document:
Date:
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