Request Scholarship

Yes! O4K may publish my story!No Thank You
* By allowing O4K to publish your personal details, you will help inspire other children to realize the opportunities available to them through our sponsorship program. If you choose no, we will be sure to leave out any personal specifics when publicizing a scholarship granted.

Please answer the following questions to help us identify your financial status. These questions alone will not solely determine scholarship.

My household receives WIC, Cash Assistance or any other state government assistance.
YesNo

My household income is less than 150% of the federal poverty level. (Please CLICK HERE for a link to the federal poverty guidelines. Based off of how many in your household, locate guideline amount and multiply by 1.5. Do you fall below this?)
YesNo

The child requesting scholarship is Chronically ill? Chronically ill is defined as someone who is not terminally Ill, but has been certified within the previous 12 months by a licensed health care practitioner meeting the following requirements;
1. Person is unable to perform (without substantial help) at least two activities of daily living for a period of 90 days or more because of a loss of functional capacity.
2. The person requires substantial supervision to protect himself or herself from threats to health and safety due to severe cognitive impairment.

YesNo

The child requesting scholarship is Physically Disabled. This is defined as an individual with a physical impairment that substantially limits one or more major life activities ( examples are seeing, hearing, breathing, communicating, working, walking, etc.)
YesNo

Parent/Guardian Name

Home Address

Email (required)

Upload the Most Recent Report Card

To qualify for a scholarship from Opportunity4Kids, we require that students please upload their most recent report card for school enrollment verification purposes.

It is expressly understood Opportunity4Kids is not liable for any accidents or injuries which may occur while the child is participating in the chosen activity. As a condition of accepting a Scholarship provided by Opportunity4Kids, the participant specifically waives, releases and discharges any and all potential claims for injuries or damages and specifically releases and agrees to hold harmless Opportunity4Kids, its Board Members, trustees, officers, employees and volunteers from and against any and all liability arising out of or connected in any way with participation in the chosen event/activity.

I certify that I am the parent or legal guardian of the child named above who is under the age of eighteen years old. By submitting this application, I acknowledge that I am applying for scholarship from Opportunity4Kids and that all information supplied on this application is true and correct.

Please digitally sign your name below to agree.

Home Address

Email (required)

Upload the Most Recent Report Card

To qualify for a scholarship from Opportunity4Kids, we require that students please upload their most recent report card for enrollment verification purposes.

I certify that I am 18 years of age and still currently attending k-12. By submitting my application, I acknowledge that I am applying for scholarship from Opportunity4Kids and that all information supplied on this application is true and correct.

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