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SIPS PRE SCREENING
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SIPS SCHOLARSHIP APPLICATION
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SCHOLARSHIP CHECKLIST
SIPS TRAINING & DEVELOPMENT SCHOLARSHIP
PRE- SCREENING
Scholarship Amount: Up To $1600
Name:
Phone:
Date:
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Email
ANSWER THE FOLLOWING YES NO
1. Are you 18 years or older?
YES
NO
2. Do you have a high school diploma or GED?
YES
NO
3. If located in Texas, have you applied for financial assistance through the Texas Workforce?
YES
NO
4. Have you applied for a line of credit through PayPal?
YES
NO
5. Are you employed?
YES
NO
6. If employed, have you inquired about tuition reimbursement or any other assistance that they may offer for educational purposes?
YES
NO
7. If offered a scholarship award, can you pay the difference in cost of tuition in full no less than ten (10) days before the start of your scheduled class? The remaining balance will total $5250.00 (Texas only), plus $100 for books and materials.
YES
NO
8. Can you furnish documentation required to verify the following?
· Proof of income
and
employment
· Proof to verify the number of dependents
· Denial of credit through PayPal.
· Denial of assistance from TWC (if applicable)
· Denial of assistance from employer (if applicable)
· Proof of Education
YES
NO
9. Is your household income equal to or less than $55,000?
YES
NO
Please upload a valid copy of your Identification (ID)
Delete all uploads
Choose files or drag here
Signature
Clear
Please allow seven (7) business days for processing.
Notification of eligibility is sent via email upon completion of review.
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SIPS TRAINING & DEVELOPMENT
SCHOLARSHIP APPLICATION
Application - must be filled out by applicant
1. Name
2. Address
3. Cell Phone:
4. Email
5. DOB:
6. Highest level of Education:
7. Employment Status:
8. Annual Income (Gross):
10. Marital Status:
11. Household Size:
12. No. of dependents:
13. Will this be your first time classified as a “student” since turning the age of 18?
13b. If NO, what was the focus of the degree/certificate/certification that you were seeking?
14. Are you currently enrolled, pending registration, or scheduled to attend another school and/or training program?
15. Do you have reliable transportation?
16. Are you physically capable of performing the duties associated the career path in which your seeking financial assistance?
REFERENCE- #1
Personal Reference- Must be a family member that lives near you.
Name
Address
Phone
Email:
REFERENCE- #2
Personal Reference- Must be a family member that lives near you.
Name
Address
Phone
Copy of Email:
SOURCE OF INCOME
Information submitted may be used to verify income.
1. Occupation OR list all benefits received
Employed
Self-employed
Retired
Unemployed
Student
If employed, name of employer:
Address of employer
Phone
2. Occupation OR list all benefits received
Employed
Self-employed
Retired
Unemployed
Student
Length of employment:
If employed, name of employer:
Address
Phone
Length of employment
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Scholarship Checklist
The following items must be attached to this application in order for the application to qualify to be reviewed by the scholarship committee. Applications will be returned to you if these items are not attached to this application.
Documents Checklist
Essay
Two (2) forms of ID
Proof of Texas residency
Proof of income
Denial of assistance from employer (if applicable)
STATEMENT OF ACCURACY
I hereby affirm that all the above stated information provided by me to SIPS Training & Development is true, correct and without forgery.
Signature
Clear
Date
MM
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For Office Use Only
Application Date
MM
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YYYY
Processor Name:
Approved
Denied
Decision Date
MM
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YYYY
Award Amount:
Approved by:
Interest will be charged to your account from the purchase date if the balance is not paid in full within 6 months. Minimum monthly payments required. See terms
Apply for PayPal Credit
Offer Overview
Purchases of $99+:
No Interest if paid in full in 6 months on purchases of $99 or more.
Interest will be charged to your account from the purchase date if the balance is not paid in full within 6 months.
A minimum monthly payment is required and may or may not pay off the promotional purchase by the end of the 6 months period.
No interest will be charged on the purchase if you pay it off in full within 6 months. If you do not, interest will be charged on the purchase from the purchase date at the Purchase APR applicable to your account.
For New Accounts: Variable Purchase APR is 25.74%. The APR is accurate as of 9/1/2018 and will vary with the market based on the Prime Rate (as defined in your credit card agreement). Minimum interest charge is $2.00.
Individual items that are less than $99 qualify for special financing when combined for a total of $99 or more in a single transaction.
Multiple separate transactions of less than $99 per transaction cannot be combined to meet the minimum purchase amount.
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