AGCS 1:1 Technology Fee Financial Hardship Form
Please complete this form to request payment options, prorated reductions, and/or waivers. Each request will be reviewed and handled with the utmost confidentiality and care. Specific provisions and accommodations will be made on a case by case basis. Submission of this form does not guarantee that the technology fee will be waived, reduced, modified, or accommodations will be put in place.
Email address *
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Home Address *
Your answer
Phone Number *
Your answer
Verify Parent/Guardian Email Address *
Your answer
Statement of Need: Please provide information regarding the financial hardship and the need for financial assistance and/or payment plan options. *
Your answer
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Avon Grove Charter School. Report Abuse