Unity Lutheran Christian Elementary School

A Mission Outreach of the Southern Illinois District – LCMS

TUITION COVENANT and REQUEST FOR FINANCIAL AID 2026 -2027

“Know therefore that the Lord your God is God; He is the faithful God, keeping his covenant of love to a thousand
generations of those who love Him and keep His commandments.” Deuteronomy 7:9

This field is for validation purposes and should be left unchanged.
Parent/ Guardian’s Name(Required)
Parent/ Guardian’s Name
Address(Required)
Number of people in household(Required)
Adults
Children
Please list all children in the household who will be entering grades PK – 8th at Unity Lutheran Christian Elementary School:(Required)
Name
Gender
Relationship to guardian
Grade level in 2025- 2026
 
Monthly Income
Salary
Father
Mother
Other
AFDC or ADC
Father
Mother
Other
Other Public Assistance
Father
Mother
Other
Other Income
Father
Mother
Other
Total
Father
Mother
Other
All information shared is confidential and used solely for school-related financial considerations.
To verify income, please attach a copy of your most recent federal tax return and/or two most recent pay stubs. Do not include schedules, attachments, or worksheets. Only include the 1040 or 1040EZ form. If you would like a free copy of your federal tax return, please call the Internal Revenue Service at (800) 829-1040.
Please initial each statement to indicate the statement is true:
I certify that all information provided on this application is true and complete to the best of my knowledge. I agree to provide documentation to verify any statements made in this application, if requested. I understand that failure to do so may result in the forfeiture of scholarship eligibility. I acknowledge that the student and family must meet all stated conditions to remain eligible for a scholarship.
Signature of Parent or Guardian
Clear Signature
MM slash DD slash YYYY
Signature of Parent or Guardian
Clear Signature
MM slash DD slash YYYY

FULL TUITION