2017-2018 Choice Voucher Application
A School Choice Scholarship (voucher) allows parents to use public funds to pay for some or all of their child’s private school tuition. Vouchers are created and distributed by the state government. In Indiana the following guidelines are used to determine if your family is eligible to participate in this program. After reviewing the following qualifications you may apply for Choice Scholarship by filling out the Voucher Application form within your online enrollment process. All Choice Scholarship applications must be submitted with a copy of your federal tax return. To be eligible the following guidelines need to be met:

· The student received a Choice Scholarship (voucher) or SGO grant in previous years and is income eligible

· The student is a sibling of a student that received a Choice Scholarship (voucher) or SGO grant in previous years and is income eligible

· The student is transferring from an Indiana public school and is income eligible

· To be income eligible the following guidelines must be met (see PDFs at bottom of page):
http://mooresvillechristian.org/admissions-menu/tuition-assistance

--------------------------------------------------------------------------------------------------------------------------------------------------------------

Student LAST Name:
Your answer
Student FIRST Name:
Your answer
Student GRADE for 2017-2018:
Student Home Address:
Your answer
City:
Your answer
State:
Your answer
Zip Code:
Your answer
School Corporation You Live In (Mooresville, Monrovia, Decatur, etc.):
Your answer
School Your Child Would Attend Attending Public School (school of residence):
Your answer
Parent/Guardian Full Name:
Your answer
Parent/Guardian Email:
Your answer
Parent/Guardian Phone Number:
Your answer
What School Did Student Attend LAST School Year (2016-2017)?
Your answer
Does Student Have An Individualized Education Program (IEP) Or Service Plan/Speech Services?
Did This Student Or A Sibling Receive An SGO Grant or Choice Voucher In Previous School Year?
List "Self", "not applicable", or Sibling Name Who Received SGO Grant Previous School Year:
Your answer
List "Self", "not applicable", or Sibling Name Who Received Choice Scholarship Previous School Year:
Your answer
Total # Of People Living In Household:
Your answer
Total Adjusted Gross Income In Household (please include income from jobs, child support, social security and any other household income):
Your answer
Parent/Guardian Digital Signature:
Your answer
Please Choose Monthly or Semi-Annual Billing. This choice can NOT be changed after intial Choice Voucher Application is submitted.
*Please submit a copy of your 2016 taxes to the MCA Office to complete your application. The office will notify you when your application has processed. Estimated amounts will be given to you when the office notifies you to come sign final documentation. If your income has changed from 2016 to 2017 based on job change, loss of job, etc. please fill out the Income Verification Form located in the Voucher Paperwork page on our website and return to the office with your 2016 taxes.
Submit
Never submit passwords through Google Forms.
This form was created inside of Mooresville Christian Academy. Report Abuse - Terms of Service - Additional Terms