First Name:
Last Name:
Email Address:
First Name of Student or Child:
Last Name of Student or Child:
Child's Age:
Your Relationship to Child:
Estimated Gross Family Income:
Number of Adults in your Family:
Number of Children in your Family:
Do you receive other financial assistance? If so, please list. (e.g. free or reduced meals, food stamps):
Please explain why you would like to be considered for financial aid.:
What Program are you Applying for Scholarship for?:
Have you received scholarship funds from SCRAP before?:
If Yes, When?:
How did you hear about our scholarship program?:

The following questions about the scholarship applicant(s) help SCRAP know whom we are serving and how we can best support our communities. Thank you!
Does the scholarship applicant live with a disability?:
Within the broad categories below, where would you place the applicant's racial or ethnic identity?:
How does the applicant identify their gender?:

Thank you for applying for a SCRAP scholarship. We will contact you shortly for more information, if needed. If you have any questions, please reach out to