CLSTO Scholarship Application

ESA - Please note if you are planning to use ESA funds at any time during the 2025-2026 school year you do not qualify for the Christ Lutheran School Tuition Organization Scholarship. Please do not complete this application in that event.

Instructions - Complete all required fields. Your application may be delayed or disqualified if submitted without the requested documentation.

Please be prepared to upload the first 2 pages of your Federal Tax Return form 1040 submitted for 2024.

Please be prepared to upload a narrative regarding the need for this scholarship

Please be prepared to upload any scholarship letters received from any STO other than the CLSTO. Do not upload CLSTO letters.

Application Deadline is

Friday, May 2, 2025

Parent Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

First Student Name and Grade*

Student nameGrade 25/26

School Attending*

Annual Tuition*

Second Student Name and Grade

Student nameGrade 25/26

School Attending

Annual Tuition

Third Student Name and Grade

Student nameGrade 25/26

School Attending

Annual Tuition

Fourth Student Name and Grade

Student nameGrade 25/26

School Attending

Annual Tuition

1. Number of people in your household - You must include everyone living in your household , related or not. Include yourself, spouse, relatives, friends, and all children living with you, including dependents who are in college. Do not include foster children, (see below) This must reflect the number of entries below.*

2. Household Income: Please read the following instructions to make sure the information is filled out completely.

A. Names: List the first and last names of every person living in your household. Total number must match the number listed in #1 above whether they receive income or not. If no income is received, mark the no income for that entry.

B. Gross income and how often it is received: Following each person's name, list each type of income received every month.

Earnings from work: List gross income from work (wages, salaries, tips, commissions). This is not the same as take-home pay; it is the amount earned before taxes and deductions. Gross earnings should be listed on your pay stub. If self-employed, you may report income after expenses (your own business, freelance work, farm, or rental property).
Welfare, Child Support, Spousal maintenance: including - TANF, General Assistance, General Relief, etc. NOTE: Food Stamps and FDPIR benefits are not included as income.
Pension, Retirement Social Security: include - Supplemental Security Income (SSI), Veteran's (VA) benefits, and disability benefits.
Other income: net rental income, annuities, net royalties, regular contributions from persons not living in the household, income from estates and trusts.

Example of Gross income and how often if is received.

$100/monthly; $100 twice a month; $100/every other week (EOS) $100/ monthly

List everyone in the household

	Name of each person in the household - First Name, Last Name	Earnings from work before deductions	Welfare, child support, spousal maintenance	Pension, retirement, social security	All other income	No income "X"
Individual 1
Individual 2
Individual 3
Individual 4
Individual 5
Individual 6
Individual 7
Individual 8

Total Annual Household Income: Add up all income from the chart above.*

3. Foster Child - If this appliation is for a child who is the legal reponsibility of a welfare agency or court and is currently living in your household, please provide the following information about that child.

Foster Child's Name

Foster Child's Personal Use monthly income

Please check all that apply. If you have copies of previous award letters, please upload them below.*

Transferring from a public school or charter schoolStarting KindergartenDependent of United States Armed Forces stationed in ArizonaPrevious "Switcher/Overflow/Plus" Scholarship beneficiary (from CLSTO or other STO)Previous Corporate Scholarship beneficiary (from other STO)Previous Original Scholarship beneficiary (from CLSTO or other STO)Have not received STO scholarship in the past.Moved from out of state before enrolling in private schoolHomeschooled before enrolling in private school

Upload any previous award letters from STO's other than CLSTO - do not upload any letters received from the CLSTO

Please complete a narrative: Please explain reason for applying: whether it will be short or long term and any unusual circumstances including dates of separation/divorce, custodial agreements. etc. Please also explain any changes in income from the tax return provided.*

Federal Tax Return: Please upload a copy of the responsible person's most recently filed 2024 Federal Income Tax Return. Only pages 1 and 2 of your form 1040 are required. This will be held in strictest confidence. W-2's or paystubs will not be accepted. If you are filing an extension, a copy of your IRS extension paperwork and the first 2 pages of your 1040 return from 2023 are required. If you qualify for a scholarship, this will "hold' your scholarship. We will not release the scholarship until the 2024 federal tax return has been received and reviewed.*

By signing this document, I declare that the information on this form, to the best of my knoweldge, is correct and all income has been reported.

Name of person completing this form*

Signature*

CLSTO deos not accept recommnedations; it is a need based STO.

A school tuition organization cannot award, restrict or reseve scholarships solely on the basis of a donor's recommendation. A taxpayer may not claim a tax credit if the taaxpayer agreed to swap donations with another taxpayer to benefit either taxpayer's own dependent. A. R. S. 43-1603(C).

Scholarship Application

Parent and Student Information

Information Required by the State of Arizona