Request edit access
In order to be considered for this fund for cafeteria use, similar to the Federal Free and Reduced Lunch Program, please fill out the following. If you have any questions, please direct them to Joe Gerardi, Vice President of Mission, at
Student Last Name
Student First Name
Parent/guardian last name?
Parent/guardian first name?
Parent/guardian email address?
How many people live in your household?
What is your adjusted annual income? (This is the figure on line 7 of your 2018 tax form 1040.)
Have you received a DLS tuition assistance award?
Describe any special circumstances we should consider in determining eligibility for this fund.
I certify that the above information is true and correct to the best of my knowledge.
De La Salle Collegiate reserves the right to request supporting documents for any information provided above.
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of De La Salle Collegiate.
Terms of Service