Day School Scholarship Application

Member Name*

First Last

Member Email*

Children's Names

Child #1	Child #2	Child #3

Children's Ages

Child #1	Child #2	Child #3

Child 1 - School Attending:

Child 2 - School Attending:

Child 3 - School Attending:

Parents Will Pay:

Child #1	Child #2	Child #3

2018 Gross Earnings

Total number of children in family:

Please attach a statement of any extenuating circumstances.

Max. file size: 32 MB.

Scholarship Information

You must apply for aid to the institution(s) indicated below before your application will be considered by NSSBE.

Have you applied to the school for a scholarship?

Has the school responded?

What amount of money was awarded?

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