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Application form

Instructions and Guidelines

By filling out our application you are applying for tuition assistance with Lexington Education Foundation for your child or children enrolled in or attending a private Arizona school. If applying for more than one child, please complete one application PER child and provide a separate set of documents required specifically for each child. A copy of the first two pages of your latest federal income tax return is to be attached to every application.

 As a parent or guardian, you must apply for a scholarship every school year. Incomplete applications will not be considered for a scholarship. Please make sure you have read the instructions carefully, answer all questions, and include all the necessary information and documents required when applying. Please keep a copy of the completed application for your records.

Items Needed to qualify for Individual, Switcher, and Corporate Scholarships

Gross Income verification for each member of your household.  

  • Any individuals living as one economic unit and sharing housing income and expenses is considered a member of the household. This includes grandma, uncle, and even an unrelated individual if they are living with you and share income and expenses. Documents needed include:
    • Copy of the first 2 pages of all individuals 2015 tax form.

Additional documentation will be required. These documents include:

  • Previous tax credit scholarships received and/or records of previous public school attendance
  • School Verification Form is included in the application packet
  • Award letters from other STOs for your child or children are also acceptable forms of verification. 
  • If the child is applying for the Disabled/Displaced Scholarship
  • Current or expired MET, IEP, or 504 is required. 
  • Displaced Student Applicant Verification Form, also included in application
  • Information Release Form for the Disabled/Displaced Scholarship Program must be completed

If you have any questions or having trouble filling out your application, we are happy to help you through the process. Please call us at (623) 349-4322 or send us an email at info@LexingtonScholarships.com. Once we receive your application, you will receive a confirmation via email.

Thank you for taking the time to apply with Lexington Education Foundation. We are excited to be a part of your child’s future.

If you have any questions or having trouble filling out your application, we are happy to help you through the process. Please call us at (623) 349-4322 or send us an email at info@LexingtonScholarships.com . Once we receive your application, you will receive a confirmation via email. 

Thank you for taking the time to apply with Lexington Education Foundation. We are excited to be a part of your child’s future.

All applications must be fully completed and all required documents must be attached and sent via email to
info@LexingtonScholarships.com

Student Information












SCHOLARSHIP ELIGIBILITY

Scholarship Choices

Household Income

Household Members – List the first and last name of each person living in your household, related or not (such as grandparent, other relatives, or friends). You must include yourself and all children living with you. Attach another sheet of paper if needed. 

Gross Income and Frequency – Next to each person’s name list each type of income received and how often it was received (weekly, Bi-weekly, 2x month, monthly, or yearly). 

  1. Earnings from work: List the *Gross income for each person, not the take-home pay. *Gross income is the amount earned before taxes and other deductions. 

  2. Welfare, child support, alimony: List how much and how often it is received. 

  3. Pensions, retirement, Social Security: List how much and how often it is received. 

  4. All other income: Include – Supplemental Security Income (SSI), Worker’s Compensation, Disability benefits, Veteran’s benefits (VA benefits), Unemployment, Strike benefits, Regular contribution from people who do not live in your household, net income from self-owned business, farm, or rental income, and ALL OTHER INCOME. NOTE—If you are in the Military Housing Privatization Initiative or get combat pay, do not include these allowances as income.

Check if household member has no income – If the person does not have any income, check the box. Attach an additional sheet, if necessary

Name Gross Income and Frequency
Household Members
(list everyone in Household)
Earnings from Work Before Deductions Welfare, child support, alimony Pensions, retirement, Social Security All Other Income Check if NO Income
No
No
No
No
No

Foster Child

If this application is for a child who is the legal responsibility of a welfare agency or court and is currently living in your household, please provide the following information about that child (please list additional foster children on a separate Financial Information Form).


PLEASE READ THE FOLLOWING AGREEMENT STATEMENTS

  • Scholarships awarded to the applicant(s) must be used as allowed by Arizona law solely for tuition expenses at a qualified private school of the applicant’s choice. Any portion unused must be returned by the school to Lexington Education Foundation for reallocation.


  • The applicant is not receiving Empowerment Scholarship Account (ESA) money from The Arizona Department of Education and is not applying for an ESA from the Arizona Department of Education. A student receiving ESA money from the Arizona Department of Education cannot receive any funds from any school tuition organization for that same academic year.


  • Lexington Education Foundation has absolute and sole discretion in awarding scholarships.


  • Scholarships are distributed without regard to ethnicity, sex or handicap. Scholarships are only for the current academic year and continuing aid is based upon the applicant’s eligibility and funds available.


  • A school tuition organization cannot award, restrict or reserve scholarships solely on the basis of donor recommendation. A taxpayer may not claim a tax credit if the taxpayer agrees to swap donations with another taxpayer to benefit either taxpayer’s own dependent.


  • Household family income is not solely used to determine eligibility, but is one of many factors used to determine scholarships awarded. Applicant(s) family’s current annual household income is reviewed and will provide the necessary information for verification of that income.

Please Sign, Print, and Date

I promise to the best of my knowledge all of the information on this application is true and that the income reported is correct.


Public School Verification Form

This information is to be completed by the public or charter school. Depending on the student’s current enrollment status, you may need to provide information for both the current school year and the prior school year. If the student attended more than one public school during a school year, provide information for all public schools (a separate form for each school may be attached).

Applicant Information





School Information




For Public or Charter School Use Only




Information Release Form for the Disabled/Displaced Scholarship Program

School Tuition Organization: Lexington Education
Foundation


STO Contact Person: Kelsey Johnston


Phone: (623) 349-4322


Email: kelsey@lexingtonscholarships.com




*ATTN* Parents must submit this form to the Arizona Department of Revenue

Please fax form to:

(602) 716-7991

Attn: Karen Jacobs

Office of Economic Research and Analysis

Arizona Department of Revenue

Or email to:

kjacobs@azdor.gov

Displaced Student Applicant Verification Form









Please return this form with your application and Lexington Education Foundation will submit it to the Arizona Department of Revenue.

VERIFICATION (to be completed by DES)

Student QUALIFIES for the Displaced Scholarship program in accordance with A.R.S. 43-1505
Student DOES NOT QUALIFY for the Displaced Student Scholarship program due to the following:
There is no indication that the child was in foster care in Arizona pursuant to A.R.S. Title 8, Chapter 5

DES Verification:


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