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Scholarship Lunch Application

  1. JCPRD Form Center Header

  2. Scholarship Application
    (Johnson County Residents Only)


    To apply for a scholarship, please provide all of the information requested below. Missing information or documentation will delay a determination of your eligibility. Please call us if you have any questions.

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  4. Enter one (1) parent/guardian name.

  5. Enter one (1) parent/guardian name.

  6. Family Member Information

    In this section, please list names and ages of family members residing in your household and receiving support from your family income.
    (These individuals must be listed on your income tax forms unless born during the current year.)

  7. For this section, you must provide the following documentation:


    1. Free or reduced lunch award letter from your school.

    2. Proof of residency.


    You may scan, photograph, or screenshot these documents if they are not electronic.

  8. Browse for the document on your computer.

  9. Browse for the document on your computer.

  10. If you do NOT have a way to upload these files...

    If you don't have access to the electronic versions of the Free or Reduced Lunch Award Letter or Proof of Residency, you may fax them to (913) 831-6336.

    Or, you may bring to the address below:

    6501 Antioch Road
    Merriam, KS 66202

  11. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  12. Scholarship term runs from January 1st to December 31st of the current year. New application and documentation is required each year.

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  14. This field is not part of the form submission.