SEED Success MOST 529 Authorization Form CPS
Parent/Guardian/Student Information needed to open an account:
Parent/Guardian/Student Information needed to open an account:
Parent/Guardian, What is Your Relationship to the Child? *
Your answer
School Name *
Your answer
Parent/Guardian*
Full Name *
Your answer
Street Address *
Your answer
City & State *
Your answer
Zip Code *
Your answer
Parent/Guardian Email *
Your answer
Parent/Guardian Mobile Phone *
Your answer
Phone (alternate)
Your answer
Child/Beneficiary*
Child/Beneficiary Legal First Name, Middle Initial *
(First Name, Middle Initial)
Your answer
Child/Beneficiary Legal Last Name *
(Last Name)
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
MOST 529 Account #
(if you have an individual account already)
Your answer
Consent
I agree to inform SEED Success of any change of address for myself or the beneficiary on a timely basis. *
Required
Contact Information
Contact information for SEED Success
Judy Baker
baker@seedsuccess.org
www.seedsuccessnow.org

Address:
SEED Success
3075 S. Rangeline Rd
Columbia, MO 65201

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