LAFORCE's Early Childhood Student Scholarship Program

Please fill out the application completely and include all required documents. Any incomplete packets WILL NOT be considered for scholarship. You may submit the completed application and required supplemental documents via email to Leigh@thelaforce.org, in person, or by mail to the LAFORCE Office: 1165 S. Foster Drive, Baton Rouge, LA 70806. 

Please Note: First choice location will be considered when approving scholarship applications, but final center assignment will be based on available seats. A separate application packet must be submitted for each child in a family. **If a scholarship is approved, an enrollment application packet is required for completion at the center of registration. 

Scholarships must be re-approved each year based on funding availability. **Scholarships are only for children enrolling in infant - pre-k 4 programs. 

Sign in to Google to save your progress. Learn more
Email *
Child's First Name *
Child's Last Name *
Child's Birthdate  *
MM
/
DD
/
YYYY
Street Address *
Apartment or Suite Number
City *
Zip Code *
Is the child homeless? *
is the child currently approved for or receiving CCAP or Other Tuition assistance? *
Check all benefits that child is receiving below *
Required
You must submit the following documentation within 48 hours of submitting this application if your child receives any of benefits listed in the previous question. 

*SNAP- submit the most recent Benefits Letter with "Certified Through" date and child's name.

Medicaid- Submit card with student information

Social Security (SSI)- Submit most recent benefit letter with beneficiary name. 
 *
Does your child currently have an IFSP or IEP and receiving specialized services? If you select "Yes" you must provide a copy of the case information to the provider upon registration.  *
Check all visits that your child has had in the last 12 months. *
Required
Would you be open to LAFORCE providing these health screenings, if available? *
What is the name and address (including zip code) of your 1st choice childcare provider? Providers must be a LAFORCE EC Scholarship Program approved provider.  *
What is the name and address (including zip code) of your 2nd choice childcare provider? Providers must be a LAFORCE EC Scholarship Program approved provider.  *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Birth Date *
MM
/
DD
/
YYYY
Parent/Guardian Street Address *
Apartment or Suite# 
Clear selection
Parent/Guardian City *
Parent/Guardian Zip Code *
Parent/Guardian Phone # with area code *
Are you Homeless? *
Do you receive Social Security (SSI) Benefits? *
If you selected "YES" to receiving SSI benefits, you must submit your most recent benefit letter within 48 hours of submitting this application. if your child receives any of benefits listed in the previous question.  *
Please provide the name of your employer below or type "I do not work" *
Provide employer address including city and zip code or type "NA" if you do not work.  *
What is your employer phone number with area code? Type "NA" if you do not work.  *
What is your supervisor's name? Type "NA" if you do not work.  *
What is your employer or supervisor's email address?  Type "NA" if you do not work.  *
Are you in school at least part time? *
Provide the name of your school.  Type "NA" if you are not enrolled in school.  *
Provide the address of your school including city and zip code.  Type "NA" if you are not enrolled in school.     *
Provide the phone number of the school with area code.  Type "NA" if you are not enrolled in school.  *

Please tell us why you think your child should be awarded the early childhood scholarship.


*
Please select a choice below to indicate your agreement to the following family assurances.  

1. I understand that my child may not enroll in my first choice center due to seat availability.

2. I understand that transportation IS NOT provided and it is my daily responsibility to get my child to school on time.

3. I understand that my child should either be income eligible to be considered and that if my child is already receiving financial assistance (including CCAP),  they are not eligible for the scholarship.     

4.   I understand that if my child begins receiving financial assistance during the scholarship term,  their scholarship will be given to another student on the waitlist, unless assistance received doesn’t cover full
tuition amount.

5. I understand that my child must attend school at least 74% of the month (not counting excused absences), or the scholarship seat may be given to a student on the waitlist.  

6. I understand that my family is required to volunteer at least one hour per month during the scholarship term, or I may have to pay tuition and the scholarship seat may be given to a student on the waitlist. 

7.  I understand that I must attend 1 monthly parent training through LAFORCE’s Connection Camp program during the scholarship term or I will have to pay tuition and the scholarship seat will be given to a student on the waitlist.  

8. I understand that family collaboration is important and that non cooperation may result in my child being disenrolled and the scholarship seat being given to a student on the waitlist. 

9. I understand that my child must complete an academic screening before enrollment is finalized and at the end of each year of participation. 

10.  I understand a family interview is required and a scholarship compact must be signed before enrollment is finalized.  

 *
Please provide the following documents, if they apply to you, within 48 hours of your application submission via email to Leigh@thelaforce.org, in person, or via mail to LAFORCE 1165 S. Foster Drive, Baton Rouge, LA 70806.

1. Child's Birth Certificate
2. Child's Immunization Records
3. Two proofs of residence (mortgage/lease, cable, or         utility bill with your name on it)
4. If you aren't on any of the bills, you may submit a notarized residency affidavit with the government ID of the person with whom you reside that is listed on the proof of residency.
5. SNAP,  Medicaid, or SSI proofs 
6. Check Stubs from Last 2 Months (If you work)
7. Current Class Schedule (must list parent name)
8. A letter stating why you don't work or are not in school at this time. 
 *
Please type your first and last name and today's date to indicate your agreement to the following statement, "I understand that I must re-apply for scholarship funding each year because it is not guaranteed. I also understand that this scholarship is only for students who are enrolling in infant - pre-k 4 programs and not currently eligible for kindergarten enrollment." 
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms