Summer Financial Aid Questionnaire 2019
Please fill out the following form so we can review your eligibility of receiving financial aid. We will contact you in regards to whether you qualify or not and provide a promo code you can use when registering.
PLEASE DO NOT REGISTER PRIOR TO RECEIVING PROMO CODE
Please check off the weeks you're interested in receiving aid for? Please check summer schedule at
Week 1: June 24 - June 28
Week 2: July 8 - July 12
Week 3: July 15 - July 19
Week 4 July 22 - July 26
Week 5: July 29 - August 2
Week 6 : August 5 - August 9
Week 7: August 12 - August 16
Advanced Teen/YA Program (July 8 - August 2) (Must be Eligible)
Which group will your child be joining? (children on the cusp should reach out to
if you are unsure which would be a better fit.
Kids Program (Ages 7-13)
Teen/Young Adult Program (Ages 14-21)
Teen/Young Adult ADVANCED Program (Ages 14-21) * Must be eligible
Parent/Guardian Email Address
Where does your child go to school?
Is your child funded to go to this school? (i.e. Are you approved by CSE, are you suing the DOE, did you get financial aid?) Please give us any and all background.
How many children are in your family?
If more than one, where do the other children go to school?
Who is employed in the household? Where are they employed?
Parent 1? Parent 2? Other?
If your child goes to public school, do you qualify for the free lunch program?
Please list services your child is currently receiving as part of their educational or clinical treatment plan. Include expenses related to these services.
ie. Psychotherapist, Reading Tutor, etc.
Parent/Guardian highest level of education
Did not attend high school
Some high school
High school graduate or equivalent (GED)
Your child’s ethnic and racial background is:
White Caucasian – Non Hispanic
Hispanic or Latino
American Indian, Alaskan Native
More than one race
Unknown or not reported
Parent Martial Status
Single, never married
Married or domestic partnership
Please indicate annual household income (as reported on recent tax return)
$0 - $20,000
$20,000 - $35,000
$35,000 - $50,000
$50,000 - $75,000
$75,000 - $115,000
What do you believe your child will gain by participating in this program?
Please tell us any other extenuating circumstances you would like us to know.
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