Financial Assistance Application

Financial Assistance Request Form

New Hope Equine Assisted Therapy
Rider's Name

First NameLast Name
Parent or Guardian Name

First NameLast Name
Phone Number
Email
example@example.com
Total Annual Household Income from all adults in the home *
Please use AGI from most recent federal tax return if possible.
Please explain any other factors that should be taken into consideration.
Recent paystub

Cancelof
Recent paystub

Cancelof
Recent paystub (for spouse, if applicable)

Cancelof
Recent paystub (for spouse, if applicable)

Cancelof
All financial assistance is granted based on the New Hope Equine Assisted Therapy policy established by the Board.

Should your financial situation change at any time, please contact New Hope Equine Assisted Therapy to discuss your financial assistance agreement.

If you have any questions about this form, contact our Scholarship Committee Chair, Kathleen Beisly. She can be reached at kbeisly@newhopeequine.com or 918-809-4469 if you have any questions.

You will be notified of our decision before lessons begin in September or within 2 weeks if applying after lessons have begun.
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Financial Assistance Request Form