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New Scholarship Application

General Information

Select School

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Student Information

First Name

Last Name

Address

City

State

Zip

County

Please select the county this student resides in

Birthday

Please select only ONE of the following checkboxes:
	For students transferring directly from a public school and entering 2nd grade or above.
	The student is a Georgia resident who, immediately prior to receiving a scholarship, was: - Enrolled in and attended for at least six weeks, a Georgia primary or secondary public school OR - Is eligible to enroll in First grade, Kindergarten or Pre-K.
	For students entering 2nd grade or above seeking exemption from public school transfer criteria. The exemptions are listed below: - Student is currently receiving (or has received in the past) a scholarship from GaSSO or another student scholarship organization (SSO) - Student has been home schooled for the year prior - Student is zoned to attend a low performing public school based on residency - Student was subject of documented physical violence and/or verbal abuse at a public school

Please select only ONE of the following checkboxes:

For students transferring directly from a public school and entering 2nd grade or above.

The student is a Georgia resident who, immediately prior to receiving a scholarship, was:

- Enrolled in and attended for at least six weeks, a Georgia primary or secondary public school

- Is eligible to enroll in First grade, Kindergarten or Pre-K.

For students entering 2nd grade or above seeking exemption from public school transfer criteria. The exemptions are listed below:

- Student is currently receiving (or has received in the past) a scholarship from GaSSO or another student scholarship organization (SSO)

- Student has been home schooled for the year prior

- Student is zoned to attend a low performing public school based on residency

- Student was subject of documented physical violence and/or verbal abuse at a public school

Parent or Guardian

First Name

Last Name

Email Address

Confirm Email Address

Phone Number

Select the button for your 2022 Adjusted Gross Income (for GA DOR reporting purposes only):

# in Household
1	$16,988.00	$33,975.00	$54,360.00
2	$22,888.00	$45,775.00	$73,240.00
3	$28,788.00	$57,575.00	$92,120.00
4	$34,688.00	$69,375.00	$111,000.00
5	$40,588.00	$81,175.00	$129,880.00
6	$46,488.00	$92,975.00	$148,760.00
7	$52,388.00	$104,775.00	$167,640.00
8	$58,288.00	$116,575.00	$186,520.00

Terms of Service

Georgia SSO Scholarships are available February 1st – December 20th – Remember to apply annually.

I hereby authorize Georgia SSO to release this information to your designated school.