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IMPORTANT: A Parent or Legal Guardian must provide a properly completed application before we can process the application. We will use the information provided to determine eligibility for the Tax Credit for Low Income Scholarship Program. Please fill in all required boxes below with the applying students' information, and then move to the next step (1/3).









































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Household Economic Survey

Tax Credit For Low Income Students Scholarship Program

This form is to verify the income eligibility of a student for the Tax Credit for Low Income Students Scholarship Program

There are: people in my household, including all children and adults


The total annual income for all people in the household before any deductions for taxes, insurance, medical expenses, child support, etc. is:

Consent For Disclosure

Sharing Information with Other Programs

Dear Parent/Guardian: You are consenting to have your data shared with the Student Granting Organization named in your application and the Kansas State Department of Education. If you do not sign this Consent For Disclosure form, your child will not be eligible for the Tax Credit Low Income Students Scholarship Program.

Verify and Complete Application
By clicking submit on this page I am agreeing to authorize the Kansas State Department of Education to release necessary information to the Scholarship Granting Organizations that partner with KSDE as a part of the Tax Credit for Low Income Students Scholarship Program in order to determine eligibility for the students applying for the program. This information may come from federally-protected sources of information such as the student’s educational records which are protected by the Family Educational Rights and Privacy Act (FERPA) and other sensitive data such as eligibility based on income. By clicking submit I also certify that I am a parent or legal guardian of the student applying and have the legal right to authorize the Kansas State Department of Education to release the given information. I voluntarily assume full responsibility for any reasonable risks associated with disclosing such information and agree to hold the Kansas State Department of Education and its employees harmless for any and all claims, injuries, damages, losses or suits arising out of such disclosure for any acts taken within the person or person’s scope of work as a state agency employee. I understand that any misrepresentation of facts by me or on my behalf may result in the denial of the application for this program
Your application has been successfully submitted to KSDE. Please review and print the information if you would like.


If you'd like to submit another application, please click this link and enter the new information. New Form















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