EASD Fee Waiver Request
Families that qualify for the Free and Reduced Price School Meal Program may file a fee waiver request with the district to have certain student fees waived. The Elkhorn Area School District uses the same standards as the federal Free and Reduced Price School Meal Program for determining whether or not your student is eligible for a fee waiver. The District will use this information to determine waiver eligibility and to enforce policy and rules concerned with fee collection. The District may disclose this information to law enforcement officials to help them determine misuse of the waiver program.
Email address *
I am requesting a fee waiver for multiple students.
Student's Name(s) *
If you are requesting a fee waiver for multiple students, please list them below.
Your answer
School(s) *
If you are requesting a fee waiver for multiple students, please select each school below.
Required
Please select which fees or charges you wish to waive.
District-wide Fees
Middle School Fees
High School Fees
Course Name(s)/Additional Fees
Please list the course or additional fees you wish to waive.
Your answer
Does your student qualify for the Free and Reduced Price School Meal Program?
An adult household member must sign the waiver application.
I certify (promise) that all information on this waiver application is true and that I reported all of my household's income. I understand that school officials may verify (check) this information. I understand that if I purposely give false information, I may be prosecuted.
Signature of Parent/Guardian
Please type your first and last name.
Your answer
Date
MM
/
DD
/
YYYY
Address
Your answer
Click submit below before exiting this form.
If you do not click submit on this Google form, your request will not be processed.
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