Confidential Scholarship Application

Little Cubs provides scholarship assistance to families requesting assistance who meet certain financial criteria. The deadline for applying for a scholarship is February 28, 2021

If you wish to apply for a scholarship please read carefully:

Scholarships apply to one child per family.
Complete the cover sheet below and turn in your most recent federal tax return showing your annual income or your most recent paycheck stubs, and any other relevant income documentation.
Monthly tuition payments may be reduced up to 20% for qualifying students based on your income level.
Mail or drop off income documents to:
Little Cubs 6333 44th Ave SW Seattle, WA 98136. Or scan and email to Kelli Wirth. Kelli@littlecubs.org
The information you provide on this form will be treated confidentially and will only be used to determine eligibility for scholarship assistance. If you have questions, please email or call Kelli.

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Student Name

Year Enrolling

Parent/Guardian Name Applying

Email Address

Phone Number

How many family members live in your household?

Current annual household income: (income includes child support, disabilities, etc.)

I hereby declare that all of the information on this form is true and accurate. In addition, I understand that any person who knowingly and with intent files an application containing false, incomplete or misleading information will have benefits revoked. (Type electronic signature below)

Date of Signature