Scholarship Application
This application is for families in need of financial support for Eva's Heroes Programming. Please note filling out this form does not secure scholarship for programs.
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Participant Name *
Participant Date of Birth *
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Primary Diagnosis *
Parent Name *
Address *
Email address *
Phone Number *
Annual Family Income Last Year *
What is your household size? *
Please describe your family's financial need in order for the participant to receive a scholarship. *
Has the participant attended any programs in the past? If so, where? *
Eva's Heroes will select scholarship recipients based on the following criteria:
-The suitability of the participant in the program, based on age, disability and goals.
-Family's financial need.

-Scholarship levels: 25%, 50% or 75% off the Programs fee.

-Along with this application, you must provide proof of income for last year by providing the first page of last year's 1040. This
 must be uploaded to the forms section. Your application for scholarship will not be considered without the 1040.
By signing below, the parent is verifying that the information above is correct. Unless specifically indicated otherwise, the parent's signature also gives Eva's Heroes permission to include the participant in promotional and educational materials about the organization, which includes photographs and videos.
Electronic Signature *
Today's Date *
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