Blosser Center Tutoring Scholarship Application

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Thanks to generous donations, the Blosser Center can offer a limited number of need-based scholarships for the 2024-2025 school year. To be considered for a scholarship, please complete the information requested below. For questions regarding our scholarship program, please contact our Executive Director via email at suzannelagrande@theblossercenter.org.
Awards will apply to 64 sessions delivered between September 1, 2024, and June 1, 2025.
Please note that the Center will not be able to fund all requests for support that are received.

Student's Name: *

Student Gender (Optional):

Female

Male

Non-Binary

I prefer not to answer

Clear selection

Student Race (Optional):

Native American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Hispanic, Latino or Spanish Origin

Middle Eastern or North African

Unknown

I prefer not to answer

Is your student currently being tutored by the Center? *

Yes

Not yet. We have submitted our inquiry form and dyslexia diagnosis. This must be completed before tutoring can start.

Please tell us anything more you would like us to know about your answer to the above question:

Table of Income based on Federal Poverty Level (FPL) - a measure of income issued by the Department of Health and Human Services.

Find the number of dependents you can claim, and follow across until you reach the value just above your yearly total gross income. Report that column's Category.

Please review the sliding scale table above and let us know which applies.

Our family income is at or below:

Category 1 or below

Category 2

Category 3

Category 4

Category 5

Category 6

We are not on the FPL scale - please call for special instructions.

I prefer not to answer

Is there any additional information or details you would like the scholarship committee to take into account?

Parent/Guardian Name: *

Phone: *

Email: *

I understand that providing false or misleading information on any part of this application will disqualify me from any current or future tuition support. *

I understand

Parent or Guardian Signature *

Type your full name below. Your name indicates your acceptance of the terms of this application.

Date *

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