Scholarship application

This application is available to AM members in good standing (current membership) and must be used for educational or recreational events hosted by Autism McLean. Applications are reviewed and approved/denied by the AM Board of Directors. You will be notified whether the application is approved or denied. An approved application will be deducted from the Autism McLean activity fee upon approval of your child's application.

Contact information
Household profile
Household size
Household members
Financial profile
Total monthly gross household income (must be completed for processing). The following documentation must be provided by the applicant for processing: prior year's Federal Income Tax 1040 return or past 3 month's pay stubs (for all household members), or federal/state agency award (i.e. food stamps, SSI, SSDI). Include any special circumstances (medical bills, illness, unemployment).
$
$
$
$
$
$
Activity
$
$
(max $225)
Assessment of need

By submitting this application you certify that the information submitted is true and complete to the best of your knowledge.