TAX CREDIT FOR LOW INCOME STUDENTS SCHOLARSHIP PROGRAM

Scholarship Award Report

School Year 2017-2018

(Due no later than December 4, 2017)

Name of Scholarship Granting Organization______

Address of SGO______

Telephone Number of SGO______

Please provide the information below and submit by due date via mail to:

Kansas State Department of Education

900 SW Jackson St, Suite 356

Topeka, KS 66612

Date of Report: ______

Please include any eligible students that were not offered a scholarship or did not accept the scholarship and reason why on the last page of this report.

Name of Student / Scholarship Period:
August, January Semester or Both / New or Returning
Scholarship
Recipient / Qualified Private School / Amount of Scholarship
$
TOTAL / $

______

Chair of Scholarship Granting Organization Date


TAX CREDIT FOR LOW INCOME STUDENTS SCHOLARSHIP PROGRAM

Scholarship Award Report

School Year 2017-2018

(Due no later than December 4, 2017)

Continued

Name of Student / Scholarship Period:
August, January Semester or Both / New or Returning
Scholarship
Recipient / Qualified Private School / Amount of Scholarship
$
TOTAL / $


TAX CREDIT FOR LOW INCOME STUDENTS SCHOLARSHIP PROGRAM

Scholarship Award Report

School Year 2017-2018

(Due no later than December 4, 2017)

Continued

Name of Student / Scholarship Period: August, January Semester or Both / New or Returning
Scholarship
Recipient / Qualified Private School / Amount of Scholarship
$
TOTAL / $


TAX CREDIT FOR LOW INCOME STUDENTS SCHOLARSHIP PROGRAM

Scholarship Award Report

School Year 2017-2018

(Due no later than December 4, 2017)

Continued

Name of Student / Scholarship Period:
August, January Semester or Both / New or Returning
Scholarship
Recipient / Qualified Private School / Amount of Scholarship
$
TOTAL / $


TAX CREDIT FOR LOW INCOME STUDENTS SCHOLARSHIP PROGRAM

Scholarship Award Report

School Year 2017-2018

(Due no later than December 4, 2017)

Continued

Name of Student / Scholarship Period:
August, January Semester or Both / New or Returning
Scholarship
Recipient / Qualified Private School / Amount of Scholarship
$
TOTAL / $


TAX CREDIT FOR LOW INCOME STUDENTS SCHOLARSHIP PROGRAM

Scholarship Award Report

School Year 2017-2018

(Due no later than December 4, 2017)

Continued

Name of Student / Scholarship Period:
August, January Semester or Both / New or Returning
Scholarship
Recipient / Qualified Private School / Amount of Scholarship
$
TOTAL / $


TAX CREDIT FOR LOW INCOME STUDENTS SCHOLARSHIP PROGRAM

Eligible students not offered or did not accept a scholarship

School Year 2017-2018

(Due no later than December 4, 2017)

Name of Student / Application Semester:
August or January / Qualified Private School / Reason for not offering/accepting scholarship

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