JMA First Grade Service Project (private – JMA First Grade) Student Scholarship Application Student Scholarship Application This application is for JMA first grade students participating in the “Rescue Refreshers” Class Service Project. Each student who participates and completes this application will receive a $50 scholarship to be applied to their 2024-2025 tuition bill. If your tuition has been paid for 2024-2025, you will receive a credit towards 2025-2026 tuition. Student Information First Name * Last Name * Have you received a Learning to Serve Scholarship in the past? * Yes No Mailing address * Mailing address Mailing address Mailing address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal County of Residence * Select Your CountyAppling CountyAtkinson CountyBacon CountyBaker CountyBaldwin CountyBanks CountyBarrow CountyBartow CountyBen Hill CountyBerrien CountyBibb CountyBleckley CountyBrantley CountyBrooks CountyBryan CountyBulloch CountyBurke CountyButts CountyCalhoun CountyCamden CountyCandler CountyCarroll CountyCatoosa CountyCharlton CountyChatham CountyChattahoochee CountyChattooga CountyCherokee CountyClarke CountyClay CountyClayton CountyClinch CountyCobb CountyCoffee CountyColquitt CountyColumbia CountyCook CountyCoweta CountyCrawford CountyCrisp CountyDade CountyDawson CountyDecatur CountyDeKalb CountyDodge CountyDooly CountyDougherty CountyDouglas CountyEarly CountyEchols CountyEffingham CountyElbert CountyEmanuel CountyEvans CountyFannin CountyFayette CountyFloyd CountyForsyth CountyFranklin CountyFulton CountyGilmer CountyGlascock CountyGlynn CountyGordon CountyGrady CountyGreene CountyGwinnett CountyHabersham CountyHall CountyHancock CountyHaralson CountyHarris CountyHart CountyHeard CountyHenry CountyHouston CountyIrwin CountyJackson CountyJasper CountyJeff Davis CountyJefferson CountyJenkins CountyJohnson CountyJones CountyLamar CountyLanier CountyLaurens CountyLee CountyLiberty CountyLincoln CountyLong CountyLowndes CountyLumpkin CountyMacon CountyMadison CountyMarion CountyMcDuffie CountyMcIntosh CountyMeriwether CountyMiller CountyMitchell CountyMonroe CountyMontgomery CountyMorgan CountyMurray CountyMuscogee CountyNewton CountyOconee CountyOglethorpe CountyPaulding CountyPeach CountyPickens CountyPierce CountyPike CountyPolk CountyPulaski CountyPutnam CountyQuitman CountyRabun CountyRandolph CountyRichmond CountyRockdale CountySchley CountyScreven CountySeminole CountySpalding CountyStephens CountyStewart CountySumter CountyTalbot CountyTaliaferro CountyTattnall CountyTaylor CountyTelfair CountyTerrell CountyThomas CountyTift CountyToombs CountyTowns CountyTreutlen CountyTroup CountyTurner CountyTwiggs CountyUnion CountyUpson CountyWalker CountyWalton CountyWare CountyWarren CountyWashington CountyWayne CountyWebster CountyWheeler CountyWhite CountyWhitfield CountyWilcox CountyWilkes CountyWilkinson CountyWorth County Birthdate * Parent Information Parent/Guardian Name * Parent/Guardian Email * Family Adjusted Gross Income (Line 11 of your most recent federal tax filing) * $ * * *Note: This information is not used to determine eligibility. However, it is required for reporting scholarship demographic data to the GA Dept. of Revenue. Number of Dependents * Please select an option12345 Parent/Guardian Signature * signature keyboard Clear I certify that the information provided by the applicant is complete and accurate to the best of my knowledge. Submit If you are human, leave this field blank.
