A.C.T. Financial Assistance Program
Please allow 1-2 weeks to process your financial aid request. Any payment due after your request is processed must be paid in full prior to the start date of your child’s class. Class placement cannot be guaranteed if payment is not received before the class start date.

Please complete one form for each child. Incomplete applications will not be processed.

Student Name
Age
Birthdate
MM
/
DD
/
YYYY
School
Grade
Home Address
Parent/Legal Guardian Name
Parent/Legal Guardian Daytime Phone
Parent/Legal Guardian Evening Phone
Parent/Guardian Mobile Phone
Email Address
Parent/Legal Guardian Occupation
Place Of Employment
Parent/Legal Guardian Monthly Earnings (before taxes)
Please elaborate on your reasons for this financial aid request:
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