2021-2022 AAA-NEVADA SCHOLARSHIP STUDENT ADD-ON REQUEST APPLICATION
Certification, Authorization and Documentation Checklist
I certify that the information provided on the application and all supporting documentation submitted at any time is true,
correct, and complete to the best of my knowledge. I understand that if I give information that is not true or if I withhold
information and my student(s) receive a scholarship for which they are not eligible, I can be lawfully punished for fraud,
and the scholarship will be denied or revoked.
I understand that any information I provide at any time will be verified, which may include computer file matching, public
records search, IRS transcripts, and that I may be required to provide other information and/or documentation.
I authorize the release of personal, financial, and educational information for the purpose of determining eligibility and
for research.
I understand that AAA Scholarship Foundation does not discriminate because of race, color, sex, age, disability,
religion, nationality, sexual orientation, political affiliation, or gender identification or expression.
I authorize AAA Scholarship Foundation and its application management system to make this form, the information
therein, and all supporting documentation available to the appropriate state agencies as required by the law governing
the scholarships.
I agree to follow the rules and responsibilities as they apply to the program as set forth in the Parent and School
Handbook, available online at www.aaascholarships.org.
I understand that it is my responsibility to notify my child’s public school district if I intend to withdraw him/her.
I understand that it is my right and responsibility to read and understand a private school’s admission and conduct
policy before requesting to enroll my child(ren) into an eligible private school.
I understand if I am deemed eligible and am awarded a scholarship, that I am not automatically entitled to a scholarship
in the following years.
I understand that it is my responsibility to reapply and document my eligibility whenever I am required to if I accept a
scholarship.
I understand if I enroll my student(s) into a private school before receipt of a Scholarship Award Letter and School
Commitment Form (SCF), I will be responsible for their tuition, and the student(s) may not qualify for future scholarship
funding. I understand funding is not guaranteed.
Signatures (E-Signatures not accepted):
Parent/Guardian A:
Date:
Parent/Guardian B:
Date:
The following supporting documents may need to be submitted along with your completed
Student Add-On Request Application:
Birth Certificate for each Add-On Student, if not included with renewal application
Documented proof of where each Add-on Student resides, if not claimed on tax return submitted
with renewal application
Certificate of Eligibility to Transfer, if required (see next page)
Return all pages of the Completed Application and Required Supporting Documents to AAA Scholarship
Foundation by Email, Fax, or Mail. Must be postmarked/received by Monday, June 21, 2021.
Email pdf: NVDocs@aaascholarships.org * Fax: 1-888-707-2465
Mail: AAA Scholarships - P.O. Box 15719, Tampa, FL 33684-5719
AAA NV Add-on PAGE 4 OF 5 6/4/2021
