Scholarship Application

Scholarship Application
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Please note this scholarship application is applicable towards Infant, Toddler, Preschool and Day Camp programs.

We are glad that you have chosen Kama’aina Kids as your child’s early education and care provider. In an effort to make our services available to all families regardless of program and income, we have established a scholarship fund which is made possible thanks to contributions from Weinberg Foundation, First Hawaiian Bank, various other grants, as well as support from the community through the Target Circle Program, Foodland’s Give Aloha program and our very own Kama’aina Kids families.

Although we would like to be able to help all Hawaii’s families with their childcare financial needs, our funds are limited. Our scholarships range from 10%-50% of the tuition after discounts from outside sources. In order to prioritize the scholarships by need, we have a list of criteria that needs to be met in order to qualify for assistance through Kama’aina Kids scholarships. Please take a couple minutes to review the criteria. If you feel that you meet these criteria, please ask your center director or site coordinator for an application.
Please select which program you are applying for scholarship*

InfantToddlerPreschoolDay Camp

SECTION C: Household Information

Please include all members living in households that are supported by family income. Provide information on each member below. This includes you, your spouse/significant other, the children listed in Section A, any additional dependents under the age of 19 who live in your home and any dependents 19-23 enrolled in college at least half time.
Name: .
Age:
School:
Monthly Tuition:   Number
Amount paid by other sources:   Number
Amount paid by family:   Number

Household Members (Start with children in Section A) - don't worry if you can't see all the text in each box after typing

Gross Monthly Income***

	Amount
Sponsor’s income
Additional Income
Child Support Received
Tuition Assistance
Housing
Food Allowance/Stamps
Social Security
COLA
Other Income
Total Monthly Income (add rows above)

Monthly Expenses***

	Amount
Rent/Mortgage
Phone
Electricity
Water
Gas
Cable
Insurance: Life
Insurance: Auto
Insurance: Health
Loans: Car
Loans: Bank
Loans: Credit
Loans: Student
Gas/Bus Cost
Estimated Food Cost
Other
Total Monthly Expenses (add rows above

SECTION F: Letter
Please write us a letter explaining your need for tuition assistance. Describe any special financial circumstances and/or any special needs of your child that you would like to be considered. Please be specific.*
I certify that all the information provided in this application is true and correct to the best of my knowledge and all household income is reported. I understand that this information is being given in order to determine eligibility for receipt of tuition assistance and that this information will not be sold, distributed, or given to any entity other than the founders. I agree to furnish proof as required.
Signature*

Clear
Current Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
Site Applying For*
Children's Names

SECTION G: Supporting Documentation
File Upload*

Cancelof
Please provide the following documentation by uploading them using the above File Upload:
Documentation*

Pay stubs from all contributing household members for the last three (3) monthsIf self employed, a copy of your most recent General Excise Tax Return and most recently filed tax returnIf a student, a copy of your paid registration for current semesterCopy of custody degree or legal separation paperwork if applicableCopy of Birth Certificate or Foster Placement if applicableLetter of acceptance or denial from DHS/CCC
Should be Empty:

SECTION A: Children Needing Assistance