Kim Rogers Graves Can-Do Education Assistance Renewal Application

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Completion of this application gives Literacy KC permission to perform a criminal background check as necessary

Personal Information

Date:

Salutation

First Name:

M.I.

Last Name:

Address:

City:

State:

Zip Code:

Phone Number:

Phone Type:

Email:

Educational Level/Degree:

Gender:

Race/Ethnicity:

Date of Birth:

Employer:

Occupation:

Request

Amount being requested:

Date needed by:

Where does the payment need to be sent?

Additional Information:

Funding Request for:

FallSpring

Are you currently receiving or applying for other grants/scholarships or financial assistance?

Please describe below:

Please include any comments or special considerations you would like the advisory committee to consider.

Please indicate how this grant will be used if awarded.

Working towards Associates DegreeWorking towards Bachelor's DegreeObtain a certification

Field of Study?

Educational Institution?

Certification Field?

Certification Program?

Are you applying for any additional supplemental support? (i.e. tools, scrubs, or other supplies required for education)

Please explain the need and cost below.

Please write a short essay:

a. Expressing personally how your previous funding from Literacy KC impacted your education

b. Expressing if/how your educational goals have changed since last funding

c. Expressing how this grant will help achieve your goals

Scholarships will be awarded to individuals and disbursed directly to the educational institution in August and January.

Applications are accepted year-round however formal announcements will be made in April and November of each year.

Students may reapply annually up to four years if the student is making progress towards earning a degree or certification. Progress towards earning a degree includes: a minimum of 6 credit hours per semester or its equivalent, passing classes, being in good standing with the educational institution, not dropping out, and other criteria as determined by the Advisory Committee. Progress towards earning a certification will be determined on an individual basis by the Advisory Committee.

Award Amount
Varies

Deadline
Renewal applications are only accepted for fall and spring.

Spring to Fall: July 31 deadline, August 15 decision made & renewals paid out
Fall to Spring: January 15 deadline, February 15 decision made & renewals paid out

Please attach the following documents:

1. Acceptance letter to the program of your choice and a breakdown of tuition/cost.

2. Breakdown of any supplemental support requested (cost and explanation of need).

3. Transcript of previous semester grades.

ALL MATERIALS MUST BE RECEIVED BY THE DEADLINE FOR CONSIDERATION.

All the information on this form is true and complete to the best of my knowledge. I understand that any false statements made by me on this application, or any supplement materials may be grounds for rejection of my application or dismissal from any subsequent funding. Completion of this application gives Literacy KC permission to perform a criminal background check as necessary. If awarded a grant from Literacy KC I agree to share my story and photo as requested to help promote the program to others.

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