The

I Know I Can

Grant (which replaces the Last Dollar Grant) is available for qualified Columbus CitySchools graduates. This grant is intended to assist students in covering the gap that exists between yourresources and the cost of your college education. The award is renewable for up to four years in theamount of $1,200 per year based on available funds. Students must be Pell eligible and apply for the

IKnow I Can

Grant each year on or before April 15

Please read and sign:I Know I Can

may use information from all related financial aid documents and high school and/or collegeacademic records to determine eligibility, as well as monitor academic progress, retention and solicitsupport for

I Know I Can

and appropriate college personnel employed at the student’scollege(s) in the areas pertaining to admission, registration, financial aid, academic progress, retention andother related programs/areas may share information relevant to the student’s current status and/orparticipation. By signing this application, the undersigned hereby acknowledges receipt of the guidelinesand agrees to abide by such. The undersigned also agrees to waive all personal claims, causes of action,or damages against

I Know I Can

, its board of trustees, officers, employees, and associates thereof,arising from or growing out of their participation in

I Know I Can

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Please check one

: I give _____ do not give _____ permission for this completed application to beshared with other organizations that grant scholarships for which I may qualify. I will notify

I Know I Can

of any changes in the information I have provided on this application.

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Do you give

I Know I Can

permission to share information with the parent(s) or guardian(s) listedbelow:

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Yes

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STUDENT SIGNATURE

: ______________________________________________________

DATE

: ____________________

A. PERSONAL INFORMATION:(PLEASE PRINT NEATLY)

Your Name: _________________________________________ _______________________________________________ ____

Last FirstM.I.

Address: __________________________________________________________________ SS#: ____________________________ City: _________________________________ State: ________ Zip: _______________ Male: ________ Female: _______ Telephone: (Home):_________________________ (Cell):_________________________ Date of Birth: _____________________ Do you give IKIC permission to send texts to your cell phone:

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Yes

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NoEthnic Background (optional):

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African American

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Asian American

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Caucasion

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Native American

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Hispanic/Latino

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Bi-racial/Other

Preferred e-mail ________________________________________________________________________________ High School Graduated From: __________________________________________________ Year of H.S. Graduation: __________

B. PARENTAL INFORMATION:

I KNOW I CAN3798 E. Broad St.Columbus, OH 43213Phone: 614-233-9510Fax: 614-233-9512www.iknowican.org

2010-2011

I KNOW I CAN GRANTAPPLICATIONDeadline: April 15

I Know I Can

3798 E. Broad St.Columbus, OH43213Phone: 614-233-9510Fax: 614-233-9512

Name of Parent(s)/Guardian(s): __________________________________________________________________________________ Address: ____________________________________________________________________ City: ___________________________________________ State: __________________ Zip: __________________________ Telephone: _______________________________________ E-mail address ____________________________________________ Highest education completed:

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Middle School

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High School

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College

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Post-CollegeRelationship:

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Mother

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Father

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Guardian

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Other __________________ Do you reside with thisperson:

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Yes

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C. COLLEGE INFORMATION:

Name of college/university you will attend in the 2010-11 academic year

: __________________________________

(If attending a regional campus, please list that location with the name of the school).

City: ______________________State: _______ Major: _____________________

Your college ID #:

______________________ Expected date of graduation from college: __________________ Is school on semesters or quarters?: ______________________

Month/Year

You will be living:A. on campus _________B. at home ___________ C. own apartment __________ D.other ________ Are you the first in your family to attend college:

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Yes

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LIST ANY OTHER COLLEGE YOU HAVE ATTENDED:

College: __________________________________________________ Dates attended ______________ DegreeRec’d _______ College: __________________________________________________ Dates attended ______________ DegreeRec’d _______

D. ADDITIONAL INFORMATION:

1.List any extracurricular activities such as athletics, community organizations, or serviceorganizations in which you have been involved. ________________________________________________________________________________________________________ ________________________________________________________________________________________________________

Required documents to submit by April 15, 2010:

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2010-2011 Student Aid Report (SAR)

- This is e-mailed or mailed to you after filing theFree Application for Federal Student Aid (FAFSA). Remember to file the FAFSA by yourschool’s priority deadline or April 15

whichever comes first. Your SAR may be accessedfrom the FAFSA homepage at www.fafsa.ed.gov, “click on” view or print your student aidreport. Your SAR must show your EFC. Students must

Pell eligible

to receive the

IKnow I Can

Grant

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High School transcript (for first time applicants only)

– If you graduated from highschool in 2010, we will receive your grades from Columbus City Schools. You must have aminimum GPA of 2.25 to be considered for the

I Know I Can

Grant well as confirmationthat you passed all 5 parts of the OGT.