Fillable We Stand Together Scholarship Application

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We Stand Together Scholarship Application

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  • 3 check-boxes
  • 35 other fields

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K1
2 Private Academy
2300 Corporate Park Drive, Suite 200
Herndon, VA 20171 USA
877.803.3745
Thank you for your interest in K12 Private Academy. To apply for a We Stand Together scholarship, please:
1. Complete this application and parent form.
2. Complete a personal statement that briefly explains the student’s educational and/or life goals, for example what they
want to be when they grow up. The personal statement will factor significantly in the scholarship selection process and
may be submitted in any one of the following formats:
• A written personal statement not to exceed 300 words;
• A thoughtful illustration prepared solely by the student (photograph attachment);
• A poem written by the student about their achievements or future goals; or
• A letter of reference written by someone other than an immediate family member (e.g. a teacher or
community member) that describes the student’s achievements and/or future goals.
3. E
mail all requested materials as attachments to scholarshipcommittee@K12.com by July 15th, 2021 at 11:59 PM (ET).
______________________________________________________________________________________________
Student’ Ls egal Name (First) (Last)
______________________________________________________________________________________________
Today’ Dates Student’s Birthdate Race/Ethnicity
______________________________________________________________________________________________
Parent/Guardian Name Parent/Guardian Email Address
______________________________________________________________________________________________
Street Address
______________________________________________________________________________________________
City State Zip
______________________________________________________________________________________________
Phone Number (Day) (Cell)
______________________________________________________________________________________________
Student Grade Level (for school year 2020–2021) GPA (from most recent report card)
______________________________________________________________________________________________
Name of Current School School Phone Number
______________________________________________________________________________________________
Street Address
______________________________________________________________________________________________
City State Zip
We Stand Together Scholarship Application
Acellus Academy address is 11020 N Ambassador DR. Suite 120 Kansas City, MO 64153
We Stand Together Scholarship Application
INCOME INFORMATION
_________________________________________________________________________________________________
Annual Family Income Number of Family Members
REASON FOR ELIGIBILITY (See income eligibility guidelines)
If your income is above eligibility requirements, you may still apply if you have extenuating circumstances, which you may fill in
below. Documentation of extenuating circumstances must be provided with the application.
Choose which one applies:
Free/Reduced Lunch
Other Public Assistance
______________________________________________________________________________________________
(Program Name)
______________________________________________________________________________________________
(Program Contact Name) (Phone)
Extenuating Circumstances (medical bills, another child in school, etc.)
______________________________________________________________________________________________
By signing this application, you agree to the following (electronic initials accepted):
_____ If my child is granted a scholarship, my intention is for this student to complete the current school year
at the K12 Private Academy.
_____ I understand that the standard enrollment documents will also be required prior to enrollment into
K12 Private Academy.
_____ By submitting this application, I acknowledge that the student and their immediate family members are
not employed by K12 Inc. or its subsidiaries.
_____ I agree to provide verification of household income by providing the front page of the 1040 form for the
past two years or W2 forms for the same two years.
Parent/Guardian Signature (electronic signature accepted): _______________________________________________
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signature
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PARENT INFORMATION
The K12 We Stand Together Scholarship application requires a parent or legal guardian to answer the questions below.
1. K12 Private Academy students need to become familiar with working online and using email. Please describe your
child’s technical abilities with using email and other online communication tools (such as Skype, etc.). Do you feel
confident they will succeed in an online school if they receive a thorough orientation and follow-up support?
2. Student success in online education requires a collaboration between the parent (guardian) and school. Teachers will
work with your child online to provide instruction and academic support as needed. However, because the student
completes the work remotely, an adult needs to regularly monitor the student’s work and progress and assist the
student in requesting help from the school when needed. The designated adult (Learning Coach) will also receive
orientation information and support to fulfill this role. Please identify who you think the Learning Coach will be and
approximately how much time per week the Learning Coach would be available to support the student.
3. Describe how you believe your child will benefit from receiving a scholarship to K12 Private Academy. Please be as
specific as possible about your expectations regarding the impact this will have on your child’s future.
4. Please provide any additional information about your child’s past school experiences or personal history, such as
community or volunteer work, that you feel would help the scholarship committee know your child.
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We Stand Together Scholarship Application

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Completed 9 August 2021

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