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.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Avon Grove Charter School. Report Abuse - Terms of Service - Additional Terms