Dyslexia Services Foundation Scholarship Application
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Name *
Who is applying for this scholarship?
Parent or Guardian *
If the applicant is a minor please provide the legal guardian's name.
Birthdate & age *
What is the applicant's date of birth and current age?
Grade in school *
What is the applicant's current grade (or the last grade completed)?
Home language *
What language(s) is/are spoken in the applicant's home?
Address *
What is the applicant's home address?
Phone *
What is the applicant's /parent's phone number? (If none, write "none".)
email *
What is the applicant's / parent's email address. (If none, write "none".)
Financial need *
What evidence of financial need will the applicant be providing?
What is the best way for us to contact you? *
Do you have any questions or is there anything else you'd like us to know about this scholarship application?
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