Scholarship Application Form - Calendar Year 2019


Student Information:

Select the button for your 2018 Adjusted Gross Income (for audit reporting purposes only):

# in HouseholdBelowBetweenBetweenAbove
1$15,175$30,350$48,560
2$20,575$41,150$65,840
3$25,975$51,950$83,120
4$31,375$62,750$100,400
5$36,775$73,550$117,680
6$42,175$84,350$134,960
7$47,575$95,150$152,240
8$52,975$105,950$169,520

I hereby certify that the information contained herein is true and accurate to the best of my knowledge. I hereby authorize Georgia SSO to release the information provided above to the listed school.

Type your name as evidence of signature *

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