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* 1. Employee Information

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* 2. Student(s) Name(s) and grade level NEXT year. Please do not include students that will not be attending a Catholic K-12 school next year (i.e. students that will be going to college or a non-Catholic school).

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* 3. Is student eligible for EdChoice or Jon Peterson?

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* 4. Does your school of employment offer tuition assistance?

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* 5. By completing the information below, I affirm and certify that all the information and answers to questions herein are complete, true and correct to the best of my knowledge and belief. I understand that any misrepresentation, falsification, or omission of any facts called for in the application may render this application void and will be cause for rejection, whenever discovered. If I should move to a different Catholic school for employment I understand it is my responsibility to notify the Catholic Schools Office. I understand if I should leave employment in a Catholic School this award will be void.

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