Scholarship Recipient

Please fill out the form if your are a scholarship recipient and your question is about the scholarship. Otherwise contact us here.

I am a *

I am a Student Parent Other
Name Name * First Last
Email *

Confirm Email *
Phone Phone * - ### - ### ####
Student Information
Student's Name Student's Name * First Last
Student's Date of Birth Student's Date of Birth * / MM / DD YYYY
Grade Level *
State *
School District (County) *
Where are you enrolled or plan to enroll? *

Where are you enrolled or plan to enroll? Florida Virtual School With your School District's Virtual School Both Not Sure
FLVS Username
How can we assist you? *
Have you declined your scholarship with your Scholarship Funding Organization *

Have you declined your scholarship with your Scholarship Funding Organization Yes No
Please provide the name of your course and the segment. *
Are you using the Legacy or EMA portal? *
Message
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. History.—s. 1, ch. 2006-232.