T.E.A.C.H. Nevada Scholarship Application

Prior to beginning the application process, please make sure you have printed out and completed the “Center Participation Agreement” and “Authority for the Exchange of Information” forms.

Also, make sure you have all of the following documents ready to be attached at the end of the application:

  • Signed “Center Participation Agreement” form
  • Copy of Nevada driver’s license
  • Copy of a recent paycheck stub/verification of income from employer (Home Care Providers – tuition receipts for one week, tax statement, or a completed “Monthly Income & Expenses Worksheet”)
  • Copy of FAFSA report and award letter(s) (please apply for FAFSA prior to, or immediately following the submission of your application)
  • Bachelor’s degree scholarship applicants – please provide a photocopy of associate degree
  • Copy of your Nevada Registry Certificate
  • Copy of current center license
  • Signed “Authority for the Exchange of Information” form
  • Copy of college transcripts (if you have already taken college credits)


Semester you would like your scholarship to begin:*
I am applying for a:*
College you plan to attend:*
County: *
Social Security No:*
Date of Birth:*
U.S. Citizen*
How did you hear about the T.E.A.C.H. Project?*
Family Structure
Including yourself, how many people live in your household?*
Ethnicity: Used for demographic purposes only
Are you of Hispanic, Latin, or Spanish origin?*
Do you consider yourself:*
Start Date of Employment at current program:*
Center Name:*
Center Address: *
Center County*
Center Phone:*
Center Fax:*
Center License Information:*
Center or Director's Email:*
Name and position of the person authorizing your scholarship:*
How long have you worked in the field of early childhood?*
What is your current job title?*

*Administrator: center directors, assistant directors, and other administrative staff

*Family-based Professional: home care operator/provider

*Non-Teaching Professional Staff: an example of this position would be a curriculum specialist

*Non-Teaching Support Staff: examples of this position would be kitchen or custodial staff

What age groups do you teach? (Please check all that apply)*
What is your current hourly wage?*
How many hours per week do you work?*
How many months per year do you work?*
Average number of children in your classroom daily:*
Your Membership Number with The Nevada Registry:

If you do not remember your member number, contact The Nevada Registry at: 1.800.259.1906

If you are not a member of The Nevada Registry, use this link for instructions to become a member: http://www.nevadaregistry.org/career-development/apply-or-renew.html

Job #1 Employer:*
Hourly Wage:*
Job #2 Employer:
Hourly wage:
YOUR TOTAL FAMILY INCOME (spouse included) $*
Are you the primary source of income for your household?*
Do you consider yourself a single-parent household?*
Please check the box that best describes your educational history:*
If you have attained an associate, bachelor's, or master's degree, what was your Major?
Please check the box that best describes your educational goals:*
Are you currently enrolled at a community college?*
If applying for a Bachelor's Degree Scholarship, please indicate how many credits you have already completed toward your desired Early Childhood degree (you will need to include a copy of your transcripts):
What is your preferred language for learning?*
Have you applied for any other financial aid* (such as PELL Grants, Smart Start Grants or student loans)?*

*It is a requirement that all college scholarship applicants apply for financial aid: www.fafsa.ed.gov. Proof of such must accompany this application. The form is known as the "FAFSA on the web submission confirmation."

Source of financial aid:
Date of application:
Application Status:

Find more information regarding federal student aid at http://www.fafsa.ed.gov/

Note: We only encourage recipients to take advantage of PELL Grant funds they are awarded and DO NOT encourage recipients to accept student loans.

What are your professional and educational goals? Please include short and long term goals.*
What challenges do you see in obtaining your degree or certificate?*
Please submit a short statement describing your thoughts on early childhood education and why you have chosen to pursue a career in this particular field of study.*
Is there anything you would like us to consider when reviewing your application?*
I attest that the information provided on this application and the supporting documentation is true to the best of my knowledge. I understand that falsifying application information or documentation or the failure to comply with documentation requirements may result in the inability to be a participant with this program. If my participation is terminated due to my failure to comply with documentation requirements, I understand that my employer may be notified, along with the program funder. Based on this information, I am applying to T.E.A.C.H. Early Childhood® Nevada for a scholarship to help pay the cost of educational expenses. By entering my name below, I am providing my electronic signature agreeing to the above, as well as to participate in the collection of data regarding the impact of this scholarship on income, educational attainment, position changes, and quality of care.*

Please print the "Center Participation Agreement"and "Authority for the Exchange of Information" forms to be completed, signed, and attached for submission with your application.

In order for us to process your scholarship application, please make sure the following items have been attached:*

Note: Additional required forms will be provided upon being awarded a T.E.A.C.H. scholarship.

Attachments: to upload multiple attachments, press Ctrl while selecting the desired documents. If you prefer, you can send your supporting documents (your name must be on all documents):
  • by fax to 775-857-3179
  • or by mail to 240 S. Rock Blvd., Suite 143 Reno, NV 89502
Upload supporting documentation file(s):
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