Scholarship Renewal?

Yes_____

No_____

UNITED WAY OF SOUTHERN NEVADA TUITION ASSISTANCE PRE-K

SCHOLARSHIP (T.A.P.S.)

2014-2015 Scholarship Application

*Please

submit one (1) complete application packet per child

*Complete application is to be submitted to a UWSN partner Child Care
Center
*T.A.P.S. is funded for one full year based on available funding and is
awarded on a first come first serve basis.
*Once child is enrolled in a partner center, transfers are rarely allowed.
Please Print
Applicants Name: _________________________________________

Todays Date:________________________

Relationship to Child: _____________________________________

Childs Name:___________________________________________ D.O.B.:_______________

________

FAMILY CHECKLIST: PLEASE CHECK OFF EACH ITEM, ATTACH TO APPLICATION, AND PUT
CHILDS NAME ON EACH DOCUMENT BEFORE SUBMITTING
________

Scholarship Application completed (pg. 1 - 5)

________

Parent Contract signed and completed (pg. 4-5)

________

Keep the Parent Copy of the Parent Contract (pg. 6-7)

________

Proof of denial letter from Child Care Subsidy, if applicable

________

Proof of Household Income for all adults in household; please provide the following:

Current income tax return (2013) if the adults filed separately, you must provide all
filed tax returns
________

Copy of Birth Certificate for child applying for T.A.P.S.

Page 1 of 8

________

Copy of current immunization record for child applying for T.A.P.S.

For UWSN Use only

Approved
%FPG
Denied
Reason
Date Parent Notified
Logged

UNITED WAY OF SOUTHERN NEVADA TUITION ASSISTANCE PRE-K

SCHOLARSHIP (T.A.P.S.)
Scholarship Application
Please complete the entire application and provide proof of household
Incomplete applications will not be accepted and/or automatically denied.
Applicants Name: _________________________________________
Childs Name:___________________________________________

income.

Date:________________________
D.O.B.:_______________________

Main Contact Number: __________________________ Alternate Contact Number: _______________________

Current street address: _______________________________________________________________________
City: _______________________________

State: __________________ Zip Code: ______________________

Email address: ________________________________________________

Preferred form of contact (please select one):

Email

Which
UWSN
Partner
Childcare
_______________________________________________
Family Status:
Total Family members in household:

Phone

Center

________

are

Mail
you

Adults: ________

interested

in:

Children: ________

* Income verification for all adults counted in Family Status must be included with
application*
I am applying for:
Full time ________
________
$57.50 weekly co-pay
co-pay

Part Time/5 days ________

Part Time/3 days

$28.75 weekly co-pay

$17.25

Infant/Toddler ________ (6 weeks 2 years of age ONLY)

$67.30 weekly co-pay and Full time ONLY.
Page 2 of 8

weekly

Is this a renewal of your scholarship? Yes_____ No_____

Full-time is Monday Friday between the hours of 6 a.m. 6 p.m.
Part-time is 4 hours in the morning, before noon, either 5 days a week or 3 days a
week (based on centers availability for part-time)
Child/Children MUST be at the center no later than 9 a.m. Monday - Friday

UNITED WAY OF SOUTHERN NEVADA TUITION ASSISTANCE PRE-K

SCHOLARSHIP (T.A.P.S.)
Scholarship Application (contd)
Please explain in detail the reasons how enrolling in preschool will benefit you and your
child. (attach statement if needed)

I attest that all information provided in this scholarship application is true. By signing below, I grant
permission to the childcare center and its partner, United Way of Southern Nevada (UWSN), to use
sources available to them to verify the information provided by me.
Parent Name (print): ___________________________________________________________
Parent Signature: ______________________________________________________________
Childs Name (print):
Page 3 of 8

Date: ___________________________________

UNITED WAY OF SOUTHERN NEVADA TUITION ASSISTANCE PRE-K

SCHOLARSHIP (T.A.P.S.)
PARENT CONTRACT
page 1 of 2
I,
childs name)

(print name), parent of,

(print

Have read, understand and will agree to the following: (please initial each item)
I will engage in a total of 96 Family Engagement and/or volunteer hours each scholarship year,
at a minimum of 8 hours per month while receiving tuition assistance.
I understand that attendance is mandatory at all United Way of Southern Nevada Family
Engagement Resource Center sponsored classes, workshops and/or meetings at the preschool/center.
I will sign the appropriate documentation after completing family engagement hours at the
preschool/center as needed by the centers Director.
I will register on the United Way of Southern Nevada/ Volunteer Centers website and enter my
family engagement/volunteer hours monthly.
I will contact and enroll my child at the UWSN Partner Center within 2 weeks of my award letter
and accept final decision of placement based on Center Directors approval.
I agree to pay for one (1) current week of tuition on my childs first day of preschool.
In addition, I agree to pay a minimum of two (2) weeks co-payments in advance to the center
on my childs first day of preschool.
No pre-payment of co-pays will be reimbursed if I choose to withdraw my child from the Center.
Provide the Center with a two (2) week written notice before withdrawing my child from the
Center.
Two-week tuition pre-payment will be applied to my childs tuition for the last two (2) weeks of
attendance when I have given a 2 week written notice to withdraw.
To report any and all financial assistance that I may receive for my children from any and all
resources, including but not limited to employee benefits and childcare subsidy.
I will comply with all parts of this Parent Contract and respond to all requests for information
within ten (10) day s of the request or forfeit my childs tuition scholarship.

Page 4 of 8

United Way of Southern Nevada reserves the right to terminate a families TAPS eligibility based
on inappropriate behavior and/or conduct by either a family member or the child.
I understand that the decision to transfer to a different United Way Partner Center is limited and
may not be granted.
Sign a Parent Consent form to participate in the Child Observation Record (COR) assessment.

UNITED WAY OF SOUTHERN NEVADA TUITION ASSISTANCE PRE-K

SCHOLARSHIP (T.A.P.S.)
PARENT CONTRACT
page 2 of 2
Agree to fulfill the terms of the parent contract and abide by all rules and regulations of the
Center.
Agree to bring my child to the Center (no later than 9:00 a.m. daily), on all scheduled school
days with a maximum of two (2) excused absences per month.
I understand that any child with more than twenty-four (24) unexcused absences will result in
the termination of the childs scholarship.
I understand that any parent/family that does not keep current with their monthly family
engagement/volunteer hours will face termination of the childs scholarship.
Definition of Absences
Excused Absence:

Child is at home ill, with a doctors note

Child was sent home by Center due to illness

Unexcused Absence:

Child does not show up for school on a regular school day

Child/Family on vacation (will count towards unexcused absences and family MUST continue to
pay weekly co-pays)

Family Engagement/Volunteer Hours can be earned by:

Attending a United Way of Southern Nevada Family Engagement Resource Center sponsored
family event, class and/or workshop
Attending/volunteering at one or more United Way of Southern Nevada approved communitybased event
Attending/volunteering at one or more of the approved list of activities/events on the Volunteer
Website
Page 5 of 8

Families will not earn Family Engagement/Volunteer Hours by helping at the Center (i.e. sanitizing
toys, cleaning center, maintenance of center, art projects for teachers etc.)
Families will receive an award letter for each eligible child within 30 business days of submitting a
complete application.
My signature below indicates and acknowledges that I have read and understand the
conditions of the Parent Contract:

Parents Signature

Date

PARENT COPY
UNITED WAY OF SOUTHERN NEVADA TUITION ASSISTANCE PRE-K
SCHOLARSHIP (T.A.P.S.)
PARENT CONTRACT
page 1 of 2
I,
childs name)

(print name), parent of,

(print

Have read, understand and will agree to the following: (please initial each item)
I will engage in a total of 96 Family Engagement and/or volunteer hours each scholarship year,
at a minimum of 8 hours per month while receiving tuition assistance.
I understand that attendance is mandatory at all United Way of Southern Nevada Family
Engagement Resource Center sponsored classes, workshops and/or meetings at the preschool/center.
I will sign the appropriate documentation after completing family engagement hours at the
preschool/center as needed by the centers Director.
I will register on the United Way of Southern Nevada/ Volunteer Centers website and enter my
family engagement/volunteer hours monthly.
I will contact and enroll my child at the UWSN Partner Center within 2 weeks of my award letter
and accept final decision of placement based on Center Directors approval.
I agree to pay for one (1) current week of tuition on my childs first day of preschool.
In addition, I agree to pay a minimum of two (2) weeks co-payments in advance to the center
on my childs first day of preschool.
No pre-payment of co-pays will be reimbursed if I choose to withdraw my child from the Center.
Provide the Center with a two (2) week written notice before withdrawing my child from the
Center.
Page 6 of 8

Two-week tuition pre-payment will be applied to my childs tuition for the last two (2) weeks of
attendance when I have given a 2 week written notice to withdraw.
To report any and all financial assistance that I may receive for my children from any and all
resources, including but not limited to employee benefits and childcare subsidy.
I will comply with all parts of this Parent Contract and respond to all requests for information
within ten (10) day s of the request or forfeit my childs tuition scholarship.
United Way of Southern Nevada reserves the right to terminate a families TAPS eligibility based
on inappropriate behavior and/or conduct by either a family member or the child.
I understand that the decision to transfer to a different United Way Partner Center is limited and
may not be granted.
Sign a Parent Consent form to participate in the Child Observation Record (COR) assessment.

UNITED WAY OF SOUTHERN NEVADA TUITION ASSISTANCE PRE-K

SCHOLARSHIP (T.A.P.S.)
PARENT CONTRACT
page 2 of 2
Agree to fulfill the terms of the parent contract and abide by all rules and regulations of the
Center.
Agree to bring my child to the Center (no later than 9:00 a.m. daily), on all scheduled school
days with a maximum of two (2) excused absences per month.
I understand that any child with more than twenty-four (24) unexcused absences will result in
the termination of the childs scholarship.
I understand that any parent/family that does not keep current with their monthly family
engagement/volunteer hours will face termination of the childs scholarship.
Definition of Absences
Excused Absence:

Child is at home ill, with a doctors note

Child was sent home by Center due to illness

Unexcused Absence:

Child does not show up for school on a regular school day

Child/Family on vacation (will count towards unexcused absences and family MUST continue to
pay weekly co-pays)
Page 7 of 8

Family Engagement/Volunteer Hours can be earned by:

Attending a United Way of Southern Nevada Family Engagement Resource Center sponsored
family event, class and/or workshop
Attending/volunteering at one or more United Way of Southern Nevada approved communitybased event
Attending/volunteering at one or more of the approved list of activities/events on the Volunteer
Website

Families will not earn Family Engagement/Volunteer Hours by helping at the Center (i.e. sanitizing
toys, cleaning center, maintenance of center, art projects for teachers etc.)
Families will receive an award letter for each eligible child within 30 business days of submitting a
complete application.
My signature below indicates and acknowledges that I have read and understand the
conditions of the Parent Contract:

Parents Signature

Date

Page 8 of 8