ACA Scholarship Application

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** Click on this link for more details about ACA's scholarship program. **

Your First & Last Name

Student's Name (if same, write "Same")

Your relationship to student (if you are the student, write "N/A")

Cell phone #

Home phone #

Email address

Please note: we will use email to communicate with you regarding your application.

Home address (Street)

City

State

ZIP Code

Student's Date of Birth

Student's Pronouns

In the section below, please indicate the program title & dates of the program for which you are interested in receiving a scholarship.

Please let us know why you (or the student) is interested in the ACA program for which you are applying for a scholarship.

If you do not receive partial or full tuition assistance, would you (or your child) be able to participate in this program at this time?

Please note: EBT, WIC and Connector Care card holders automatically qualify for tuition assistance from ACA as funds allow. Alternatively, applicants can submit a copy of their latest tax return to demonstrate financial need; applicants whose gross household income falls below 65% of the Massachusetts median gross household income (source), as denoted in the chart below (based on household size), also qualify for tuition assistance/scholarships:

Gross Median Income_MA 2021

If you don’t meet the above criteria but still have a need for financial assistance, please use the Special Notes section below to explain your circumstances and upload any relevant documentation.

Please upload a copy of an EBT, WIC, or ConnectorCare Card OR most recent tax return. Please also feel free to upload any other official document verifying financial need.

Any other special notes, comments, questions? Please feel free to use the section below.

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