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TAGT Summer Scholarship Confirmation Form
You must complete this form by April 30, 2024, in order to accept the TAGT scholarship. If you have any questions, please contact Megan Kaufmann at membership@txgifted.org.
Student First Name
*
Student Last Name
*
Parent Full Name
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Email Address
*
School District
*
Please attach a copy of an acceptance letter for the summer program you will attend. Unless you request reimbursement, all scholarship checks are made payable to the the summer program directly. If you have paid in full for the summer program, please also attach a record of payment. The check will then be made payable to the scholarship winner.
*
Summer Program Name
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Email Address
*
Name of Contact Person at Camp
*
Dates of Summer Program Being Attended
*
Total Cost of Summer Program
*
Please Make Check Payable and Mail to:
*
Parent Listed
Summer Program Listed