Online Scholarship Application

Donor Information
Name
Address
Street Address Address Line 2 City State ZIP Code
Email
Phone
Tax Credit Information
Filing Status
- Married Filing Jointly
- Single Taxpayer
Tax Credit Year
- 2017
- 2018
Have you donated to an STO this year?
- Yes
- No
Total amount of $:
Donation Information
Lutheran School (Optional)
Student Recommendation (Optional)
Amount $
Payment Information
I am paying by
- Check
- Credit Card
make payable to ALSO #:
Name as it appears on card
Card Number
Expiration Date
Security Code/CCV
Signature
Date
Date Format: MM slash DD slash YYYY
How did you hear about ALSO?
What church do you attend?
Send completed form to

Arizona Lutheran Scholarship Organization
PO Box 13277, Chandler, AZ 85248
NOTICE: A school tuition organization cannot award, restrict, or reserve scholarships only on the basis of a donor’s recommendation. A taxpayer may not claim a tax credit if the taxpayer agrees to swap donations with another taxpayer to benefit either taxpayer’s own dependent. A.R.S. 43-1603 (C). Any designation of your own dependent as a potential recipient is prohibited

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