FREED 2017 - ANC Christ First Summer Retreat Financial Assistance Form
Due by July 3rd, 2017.

After you submit this form a SED summit member will contact your parent by email and/or phone to verify your request for financial aid. After which you may be granted a certain amount of financial aid (could be more or less than you requested). At that point, we will contact you and you can turn in your registration fee and forms to a Pastor, Deacon, or intern.

Why are we doing it this way?
1) We want to make sure that money we have allocated to help students in financial need is being wisely used.
2) We want to help to support not only the students who are in need, but their parents and families.
3) We want to make sure that we have an accurate record of who received financial aid, which we have not in the past

Link to this page: http://tinyurl.com/summer2017fa (case sensitive url)

Student First Name *
Your answer
Student Last Name *
Your answer
Grade *
As of 2017-18 school year
Student Cell Phone Number *
Your answer
Student email address *
Your answer
How much financial assistance are you requesting? *
Regular registration is $185.
Please give a brief description as to your reason for requesting financial assistance *
All answers are confidential and will only be seen by SED summit leaders
Your answer
Parent Contact Information
Your parents will be contacted in order to verify your request and to help our church minister to them if needed.
Parent 1 Full English Name *
Your answer
Parent 1 Korean Name (if applicable)
Your answer
Parent 1 relationship *
Parent 1 Cell Phone Number *
Your answer
Parent 1 Home Phone Number *
Your answer
Parent 1 Email Address *
Your answer
Parent 2 Information
Not required, but helpful in the event we cannot reach your first parent
Parent 2 Full English Name
Your answer
Parent 2 Full Korean Name (if applicable)
Your answer
Parent 2 relationship
Parent 2 cell phone number
Your answer
Parent 2 home phone number
Your answer
Parent 2 email address
Your answer
What will happen next
After you submit this form a SED summit member will contact your parent by email and/or phone to verify your request for financial aid. After which you may be granted a certain amount of financial aid (could be more or less than you requested). At that point, we will contact you and you can turn in your registration fee and forms to a Pastor, Deacon, or intern.
Any additional comments?
Your answer
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