Scholarship Application

Welcome to the Light Up Learning Scholarship Application.

If your child needs vision care and you’re facing financial challenges, we’re here to help!

The Light Up Learning Program ensures that every child in our participating communities has access to the vision care they need to thrive personally and academically. We are the bridge that connects and empowers optometrists, pediatricians, school nurses, and existing non-profits. We create powerful networks dedicated to transforming children’s lives through healthy eyes and clear vision.

The eye is the lamp of the body. If your eyes are healthy, your whole body will be full of light. — Matthew 6:22

Child’s Name
*

When is the child’s birthday?
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Child’s Grade?
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Referring school and/or pediatrician?
*

Is your child in need of financial assistance in order to receive eyecare?
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Yes

Does your child have private vision insurance?
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Yes

Is your combined annual household income $60,000 or less?
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Yes

Are you receiving Medicaid?
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Yes

Please provide any additional information or reasons that support your consideration for this scholarship.

Parent/Guardian Consent
*

I, the parent/guardian of the child listed on this application, hereby give consent for my child to participate in the Light Up Learning Program.

I am a school staff member and have obtained verbal consent from the parent/guardian of the above listed child to complete this scholarship application on their behalf with the understanding that if awarded the child has permission from the parent/guardian to participate in the Light Up Learning Program.

What is the best way to contact you regarding your child’s participation in our program?
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Parent/Guardian Name
*

Parent/Guardian Phone Number
*

Parent/Guardian Email Address
*

Parent/Guardian Mailing Address
*

Who is this application being completed by?
*

Your Name
*

Your Email Address
*

Your Phone Number
*

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Twenty20 Ministries is a 501(c)(3) non-profit organization.

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