Kung Fu Scholarship & Partial Scholarship Application Name * First Name Last Name Are you a parent or guardian applying for a minor? * Yes No If you are a parent or a guardian applying for a minor, please state the name(s) and age(s) of the child or children for whom you are applying Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country I am applying for: * 3-Month Scholarship 6-Month Scholarhips Year-Long Scholarship How many people are in your household? * What is your combined monthly countable household income? * Please check only one option. $0.00-$2,000.00 $2,000.00-$3,000.00 $3,000.00-$4,000.00 $4,000.00-$5,000.00 $5,000.00-$6,000.00 $6,000.00-$7,000.00 $7,000.00 and above Do you and your dependents qualify for MediCal or MediCare/ * If so, you'll be asked to provide proof. Yes No Do you and your dependents qualify for SNAP benefits * If so, we will request proof of qualification. Yes No Please share the amount of money that you are able to contribute, monthly, to the Kung Fu training. * Do you, or does anyone in your household, have a disability? * Yes No Are you, or is anyone in your household BIPOC (Black, Indigenous, Person of Color)? Yes No Please share a little bit about yourself and your present circumstances. Why would this scholarship be meaningful to you? * Thank you! Learn More About the Scholarship
