Scholarship Application A limited number of scholarship dollars are available on a need basis. If you are human, leave this field blank.A.C.T. ~ For the Children Scholarship ApplicationThe class is $100. If you believe you have financial circumstances that would qualify you for free or reduced cost tuition, please complete the Financial Disclosure Affidavit, in support of Scholarship Application below.Which court is your case in? *Family Court of the State of New YorkSupreme Court of the State of New YorkCase Number *Petitioner / Plantiff *Respondent / Defendant *Your Name *Email *Phone *What is your annual income from all sources? *Employer Information *Please enter your employers name, address, and phone number. If you are self-employed or unemployed, please indicate that in this area.Weekly gross salary / wages *Interest / Dividend Income *Please enter amounts for any other sources of income.Workers CompensationDisability BenefitsUnemployment BenefitsSocial Security BenefitsVeterans BenefitsPensions and Retirement BenefitsFellowships / Stipends / AnnuitiesNumber of members in your household, including yourself, for whom you are financially responsible. *Supporting Documents *You are required to attach to this form a current and representative paycheck stub OR a copy of the W-2 Wage and tax statement(s) that was submitted with your most recent State and Federal Income Tax returns, OR pages 1 and 2 of the most recently filed Federal Income Tax return. SignatureBy signing below, you are affirming that all information supplied with this application is accurate. To sign use your click and mouse (or finger on touch enabled devices) to draw your signature.Reset SignatureSubmit View Schedule Enroll Online Download Form Scholarship: Some need based scholarships are available. The form must be notarized so it cannot be completed online. Click here to download the scholarship form.