Swim Scholarship Application-                         Live For Brie Foundation Inc.
ELIGIBILITY

Assistance is granted on the basis of financial need.  We determine financial need based on household income and number of legal dependents.  
Scholarships are granted for one session which consists of daily 10-minute classes, 5 days a week, for up to 6 weeks.  
Scholarship recipients may pay a percentage of the program fees.
Completed applications will be processed within 10 business days.

REQUIRED DOCUMENTS

A copy of the following documents must be either uploaded to our website, mailed or emailed to us. (For security measures please white out your SSN on all documents)

Driver’s License
Last pay stub (from you and from your spouse/partner if applicable)
Your most recent tax return (e.g. complete 1040 form, federal tax return, not your W2 form).

IF APPLICABLE PLEASE INCLUDE:
A “Did Not File” taxes form (page 4 of this application) PROOF REQUIRED
Social Security benefits statement/ Disability benefit statement
Unemployment benefit statement
Child Support statement

APPLICATIONS WILL NOT BE PROCESSED WITHOUT THE REQUIRED DOCUMENTS IDENTIFIED ABOVE
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Is this application *
Required
Date *
MM
/
DD
/
YYYY
Parent Name *
First and last name
Email *
Phone number *
Address *
Legal Dependents (Provide Names and Dates of Birth) *
Requesting Scholarship For (Provide Names and Age) *
Employment Information (Provide Employer's name, job title, length of employment, and supervisor's name and phone number) *
Spouse/Partner's Employment Information (Provide Employer's name, job title, length of employment, and supervisor's name and phone number) *
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