Apply for the Special Needs Student Scholarship

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Apply for the Special Needs Student Scholarship

Apply for the Support a Special Needs Student Scholarship

This application is for families seeking financial assistance for therapy services, specialized educational programs, and related support for children from birth through 12th grade. Please complete all required fields before submitting.

Who Should Apply

Families with children ages 0–12th grade
Students needing therapy or specialized educational support
Households experiencing financial barriers

Scholarship Application

Parent / Guardian Information

Name *

First

Last

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Relationship to Student/Child *

If Other, please explain

Preferred Contact Method

Are you the primary financial supporter for this student/child? *

Does the student/child currently reside in Florida? *

County of Residence

Student/Child Information

Student/Child Name *

First

Last

Student/Child Date of Birth *

Is the student/child a U.S. citizen or otherwise eligible to receive services in the United States? *

Yes
No
Not Sure

This scholarship supports students receiving services in the United States. Additional documentation may be requested if selected.

Current Age *

Current Grade Level or Educational Stage *

Name of School, Program, or Early Learning Setting

Type of Educational Setting *

If Other, please explain

Does the student/child currently receive any special education, therapy, or developmental support services? *

Yes
No
Currently on a waitlist

Please briefly describe the student/child’s developmental, educational, or therapy support needs. *

Therapy and Educational Support Needs

Which type of support plan or services does the student/child currently receive or qualify for?

IEP (Individualized Education Program)
504 Plan
IFSP (Early Intervention)
Private therapy services
State-funded scholarship or support program
School-based support services
Other

If Other, please explain

Is the student/child currently receiving, waitlisted for, or eligible for a state-supported special needs scholarship or program (such as Florida’s Unique Abilities Scholarship)Dropdown

Which services does the student/child currently need support for? *

Speech therapy
Occupational therapy
Behavioral therapy
Physical therapy
Specialized tutoring
Learning support services
Adaptive resources / assistive tools
Specialized educational program
Early intervention services
Other

If Other, please explain

Is the student/child currently receiving these services? *

Yes, consistently
Yes, but services have been reduced
No, not currently
On a waitlist

Have financial challenges caused any therapy sessions, services, or educational supports to be reduced, delayed, or stopped? *

Yes
No
At risk of interruption soon

Please explain what services were interrupted, reduced, delayed, or are at risk.

Approximately how much funding is needed each month for therapy, learning support, or specialized services? *

Which period of support is needed most? *

Summer months
Winter months
School year
Year-round
Not sure

Which scholarship opportunity are you applying for? *

Support a Special Needs Student Scholarship
South Florida Summer Therapy Scholarship
Either available scholarship opportunity

If you are applying for the summer scholarship, will the student/child lose access to therapy services during the summer without assistance? *

Yes
No
Not sure

Please explain how continued therapy or educational support would help your student/child continue progressing. *

Household Financial Need

Please select the range that best represents your total annual household income before taxes. *

Number of people living in the household *

Number of dependent children in the household *

Parent/guardian employment status *

Employed full-time
Employed part-time
Self-employed
Not currently employed
Unable to work currently

Do you currently receive any financial assistance or public benefits? *

If yes, which programs do you currently receive or qualify for?

Medicaid
SNAP / Food Assistance
SSI
Disability benefits
Housing assistance
Reduced or free lunch
State special needs scholarship assistance
Other

If Other, please explain

Are therapy services, educational supports, or adaptive resources fully covered by insurance or another funding source? *

Yes
Partially covered
No
Not sure

Does your family currently pay out of pocket for therapy, educational support, or adaptive resources? *

If yes, what is your average monthly out-of-pocket cost?

Have financial pressures ever caused you to consider reducing therapy, delaying services, or changing your child’s educational support plan? *

Yes
No
We are currently facing that situation

Please briefly explain your family’s current financial situation and why this scholarship is needed. *

Family Statement and Certification

best services, by

Please describe your student/child’s journey, the challenges your family has faced in accessing therapy or specialized educational support, and how this scholarship would help your student/child continue progressing in therapy, school, and daily life. *

Please provide as much detail as you feel comfortable sharing. This helps us understand your child’s needs and your family’s situation.

I certify that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that providing false or misleading information may result in disqualification from the scholarship program. *

I agree

Parent/Guardian Name *

First

Last

Parent/Guardian Signature *

Clear Signature

Date Signed *

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Education Aid is committed to removing financial barriers that prevent students and graduates from reaching their full potential.

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Education Aid is registered with the State of Florida under Registration Number CH81148. A copy of the official registration and financial information may be obtained from the Florida Division of Consumer Services by calling toll-free 1-800-HELP-FLA (435-7352) or visiting www.fdacs.gov. Registration does not imply endorsement, approval, or recommendation by the State.