Application: Removing Barriers

This application to can be used to remove an economic barrier in order to apply for the T.E.A.C.H. Early Childhood® Iowa and/or the Child Care WAGE$® Iowa program.

You are welcome to fill out this form to apply for financial assistance if you have an international transcript that you need evaluated and/or translated or if you have a previous educational debt that is preventing you from going back to school.

Removing Barriers Scholarship

Name(Required)

First Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Are you employed in a child care setting?(Required)

Yes

Name of Employer

Address of Employer

Street Address Address Line 2 City State ZIP Code

Please upload your W9 here.(Required)

Max. file size: 128 MB.

International Transcript Assistance

I am requesting funds to pay for a transcript evaluation ($500 maximum).

I am requesting funds to pay for a transcript translation ($250 maximum).

International Transcript Assistance Agreement

I understand that I may be asked for documentation showing the anticipated cost to evaluate and/or translate my transcript.

Debt Assistance

I am requesting funds to pay a debt to a college or university.

Debt Assistance Agreement

I understand that funds awarded will be paid directly to the educational institution for to be applied towards my debt.

Please include a copy of the financial invoice or statement from the educational institution you are indebted to.

Max. file size: 128 MB.

Total Amount Requested(Required)

By signing below, I certify that all information is true and correct to the best of my knowledge:(Required)

Date

Removing Barriers Scholarship

All completed applications will be considered for funding. Removing Barriers funding is awarded on an ongoing basis until funds are depleted.

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