K-12 Scholarship Application for New and Returning Regina Students

Personal Information

Date *

First Name *

Last Name *

Address

Apt, suite, etc.

Country

City

State

Zip code

Email *

Phone *

Cumulative Grade Point Average (GPA) if applicable

Current Grade *

Ethnicity

Is your parent a current faculty or staff member of the Regina Catholic Education Center? *

Yes

Parish Affiliation *

Community Sponsored Activities

(Scouts, 4-H, Fall Fun Volunteer, etc.)

School Sponsored Activities

(Class Officer, Athletics, Music, Drama, etc.)

Church Sponsored Activities

(Altar Service, Free Lunch Volunteer, etc.)

Demonstrated Christian Values at Home, Church, School or Community

Please state why you feel the Scholarship Committee should award this scholarship to you. Please limit your response to 300 words preferred. *

If the applying student is currently in 6th grade or above, we request the student personally compose this short essay for the application to be considered for a scholarship.

Financial need is shown by qualifying for Regina’s Financial Aid through the School Tuition Organization (STO) of Southeast Iowa. Please check the box below to signify agreement of the following statement.

I have utilized Financial Aid through STO of Southeast Iowa and authorize Regina to acknowledge my receipt of financial aid towards tuition. If the above statement is not selected, the applicant will not be considered for a need-based scholarship.

Signature of Parent/Guardian *

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