1
2021-2022 Scholarship Application
Education Fund of Northern Nevada (EFNN) is a Nevada non-profit corporation which was formed by a group
of Nevada businessmen for the express purpose of soliciting donations and providing scholarships as authorized
under the provisions of the Nevada Educational Choice Scholarship Program (NECSP). The law governing the
NECSP allows businesses to contribute their Nevada Modified Business Tax to a qualified Scholarship Grant
Organization approved by the State of Nevada Department of Education. The Education Fund of Northern
Nevada is one of the Scholarship Grant Organizations in Nevada.
EFNN is also a qualified charitable organization pursuant to Section 501(c)(3) of the Internal Revenue Code
and as such, contributions made to EFNN are deductible for federal tax purposes as charitable contributions. All
businesses making contributions to EFNN should consult their individual accountants or other tax professionals
regarding the specific tax consequences of contributions to EFNN.
What makes Education Fund of Northern Nevada different is that the board of directors, administrators,
accountants, and office staff are all from Nevada. Our office is in Reno, Nevada and all our people are part of
the local and State community. We understand the need for private education in The State of Nevada.
EFNN Scholarship Criteria and Procedures
EFNN Scholarship grants will be made in accordance with Nevada state law and on the basis of objective and
nondiscriminatory criteria. The procedure through which scholarship recipients (“Students”) will be selected is
as follows:
1. EFNN’s scholarship committee will review completed scholarship applications received by
EFNN. An application for a scholarship grant is not considered completed until all information requested below
has been received by the scholarship committee.
2. The general criteria which will be considered by the Scholarship Committee in awarding
scholarships on an objective and nondiscriminatory basis will include, but will not necessarily be limited to, the
following:
a. financial need:
2
With respect to financial need, as required by Nevada law, scholarships will be awarded only to
individuals who are members of a household that has household income that is not more than three hundred
percent (300%) of the federally designated level signifying poverty. Please do not submit an application
unless you reasonably believe your household income is below the level that applies to you as EFNN
cannot award scholarships to students whose income is above the applicable level. For the 2021-2022
school year, the federally designated levels signifying poverty and the amount equal to 300% of each level are
as follows:
Household income is determined under the US Department of Agriculture’s Income Eligibility
Guidelines for qualification for free and reduced-priced meals and includes for all Household Members, the sum
of the following: (a) monetary compensation for services, including wages, salary, commissions or fees; (b) net
income from non-farm self-employment; (c) net income from farm self-employment; (d) Social Security; (e)
dividends or interest on savings bonds or income from estates or trusts; (f) net rental income; (g) public
assistance or welfare payments; (h) unemployment compensation; (i) government civilian employee or military
retirement, or pensions or veterans payments; (j) private pensions or annuities; (k) alimony or child support
payments; (l) regular contributions from persons not living in the household; (m) net royalties; and (n) other
cash income, such as amounts received or withdrawn from any source including savings, investments, trust
accounts and other resources. Household Member means anyone who is living with you and shares income and
expenses, even if not related.
The amount of each scholarship awarded to a Student for any fiscal year cannot exceed the maximum
amount authorized by Nevada law. For the 2020-2021 school year, this amount was $8,469. All scholarship
grants will be paid by EFNN directly to the Nevada school selected by the Student’s parent or guardian for
attendance.
3. EFNN may award scholarships for attendance at a high school or other qualified educational institution
on an annual basis. Each recipient must reapply each year. Only renewal applicants will be considered
presuming the recipient continues to satisfy all of the requirements of EFNN, Nevada state law and the
applicable Nevada school. EFNN intends to obtain reports from the Student’s school to determine the Student’s
performance at the school for which the scholarship grant was awarded.
Household Size
Federal Poverty
Guidelines
(Annual)
1
$12,880
2
$17,420
3
$21,960
4
$26,500
5
$31,040
6
$35,580
7
$40,120
8
$44,660
For each additional family member add
$4,540
300% of Federal
Poverty Guideline
Amount
$38,640
$52,260
$65,880
$79,500
$93,120
$106,740
$120,360
$133,980
3
Thank you for choosing to Education Fund of Northern Nevada to facilitate your Nevad
a Choice”.
PLEASE RETURN THE COMPLETED APPLICATION TO:
Education Fund of Northern Nevada
Attn: Scholarship Committee
P.O. Box 10480
Reno, NV 89510
Applications
FOR RETURNING
HIGHSCHOOL STUDENTS
ONLY
must be received at the above
address by June 1st, 2021!
Applications will not be accepted in person or
via email
1
2021-2022
EFNN Scholarship Application
SCHOLARSHIP APPLICATION
1. REQUIRED DOCUMENTATION: All of the following must be provided for each Household
Member of the Student. PLEASE NOTE: IF THE STUDENT CURRENTLY QUALIFIES FOR
FREE OR REDUCED PRICE MEALS OR MILK, YOU MAY PROVIDE PROOF OF THAT
QUALIFICATION IN LIEU OF ANY OTHER DOCUMENTATION REQUESTED BELOW.
(a) A tax transcript for the 2020 federal income tax return that has been filed. This must be obtained
from the Internal Revenue Service via its website (irs.gov), or via phone.
(b) A copy of your 2020 Federal Form 1040 U.S. Individual Income Tax Return.
(c) If you have not filed your Federal Income Tax Return for 2020, a copy of your filed Application
for Extension of Time to File U.S. Federal Income Tax Return. (Please note the application will be
considered incomplete until the return is submitted). Tax returns must be submitted before the
application deadline of June 1st 2021.
(d) Copies of all 2020 W-2 forms and Tax Statements.
(e) Copies of all 2020 Form 1099s.
(f) Copies of all supporting tax schedules if you have income/loss from any of the following as to
your most recently filed form 1040, 1040A or 1040-EZ that you are providing in response to item
(a), above:
a. Business - Send Schedule C and Form 4562 Depreciation and Amortization
b. Farm - Send Schedule F and Form 4562 Depreciation and Amortization
c. Rental Property - Send Schedule E
d. S-Corporation - Send Schedule E, Form 1120S, Schedule K-1 and Form 8825
e. Partnership - Send Schedule E Form 1065, Schedule K-1 and Form 8825
f. Estates and Trusts - Send Schedule E, Form 1041 and Schedule K-1
(g) Provide supporting documentation for each category of Non-Taxable Income listed in the Schedule
provided at Item III. in the attached Application Information Form.
(h) Transcript from the Student’s most recent high school.
NOTE: It is recommended to wait and send the application and all supporting documentation
together. Please send in a complete application before the deadline of June 1st 202
1
Date
Application Information FOR RETURNING STUDENTS ONLY
Name and Phone Number of School Student Desires
to Attend if Grant Awarded:
School:
Phone Number:
Name and Phone Number of Student's Current
School (if different than above):
School:
Phone Number:
I. STUDENT INFORMATION
Last Name First Name M.I.
Birth Date
Ethnicity Gender
Grade level in 2021-2022
_
Have you previously been awarded a scholarship
by Education Fund of Northern Nevada?
If yes, list year(s)
Street Address Line 2
State
Zip Code
Cell Phone Number
Street Address Line 2
State
Zip Code
II. PARENT/GUARDIAN AND HOUSEHOLD INFORMATION
First Name M.I.
Date of Birth (MM/DD/YYYY)
Last Name
Street Address Line 2
Student Current Residence Information
Street Address
City
Home Phone Number
Primary Residence Information
(if different from above)
Street Address
Yes
No
Does this student have a disability?
Yes
No
Email Address (optional)
City
Social Security Number
Primary Phone Number
City State Zip Code
Home Phone Number Cell Phone Number
E-Mail Address
Marital Status Relationship to Student
Occupation Employer
Religious Affiliation (optional)
Another Co-Applicant Parent or Guardian is living in my household.
Yes
No
Parent or Guardian Information - Co-Applicant
Last Name First Name M.I.
Social Security Number Date of Birth (DD/MM/YYYY)
Primary Phone Number Secondary Phone Number
E-Mail Address
Marital Status Relationship to Student
Occupation Employer
Religious Affiliation (optional)
Household Information
Number Household Members
(any person living with you and sharing income and expenses, even if not related)
Names of Household Members Relationship to Student
III. NON-TAXABLE INCOME
List total amounts (annually) for all household members listed above that is received for each type of non-
taxable income:
A. Child Support Received
B. Worker's Compensation
C. Social Security or Disability
Benefits not taxed
D. Welfare and/or Aid for Families
with Dependent Children (AFDC/ADC)
D. Temporary Assistance for Needy
Families (TANF)
E. Other Non-Taxable Income
IV. OTHER TUITION ASSISTANCE OR SUPPORT
List the Amounts of all other forms of Tuition or other Educational Support or Assistance the Student will
Receive or is Expected to Receive.
A. Financial Aid or Tuition Assistance from School Student
is Applying for Scholarship from EFNN to Attend:
B. Support from Friends/Relatives/Employers/Other Educational Grants, etc.
C. Funds to be Deposited Into an "Education savings account" for
the 2021-2022 School Year pursuant to SB 302 enacted by
the 2016 Session of the Nevada Legislature.
D. Funds from any other Nevada Choice Scholarship Grant Organization such as
EFNN.
V. EXPECTED CHANGES IN INCOME, IF ANY
Do you expect any material changes in income for 2021?
Yes
No
If Yes, please explain and provide the expected amount of the change, whether positive or negative.
The undersigned Applicant and Co-Applicant represent and warrant that the information provided in this
scholarship application is complete, true and correct in all material respects. I acknowledge and agree that
any failure to provide such complete, true and correct information is grounds for immediate revocation of any
scholarship awarded as a result of the information provided in this Application. In addition, I hereby
authorize any Nevada school receiving scholarship funds from EFNN for the Student named in this
application to receive any and all transcripts and/or other academic reports for the Student for any year as to
which such scholarship funds were provided. I also declare that I have contacted the current school and school
district my child is attending as to our intentions to transfer to a private school. All grants are subject to
availability of funds and regardless of the amount of any grant awarded by EFNN, actual grants shall not
exceed the amount required to fully fund the Student's 2021-2022 approved educational costs after giving
effect to all receipts of the types outlined in Section IV, above. All 2021-2022 school year scholarship
applications must be received by June 1st, 2021. Completed applications must be mailed to: Education
Fund of Northern Nevada, ATTN: Scholarship Committee, P.O. Box 10480, Reno, NV 89510.
Applications are not accepted in person or via e-mail.
Signature of Applicant Signature of Co-Applicant