BAX Winter 2021 Virtual Classes - Financial Assistance Inquiry Form

BAX Winter 2021 Virtual Classes - Financial Assistance Inquiry Form

Table of Contents:
I. Overview of Programming
II. Financial Agreement
III. Enrollment Information
IV. Family Information
V. General Financial Information

I. Overview

Due to reduced class offerings and greater economic limitations as the result of Covid-19 closures, BAX's capacity to provide financial assistance has been significantly impacted. We urge families to register within the subsidized tiers available. Please note that this inquiry form does not guarantee a financial assistance offer.

That said, as we assess our term enrollment and capacity this fall and beyond, we are gladly collecting requests for more aid. We accept applications on a rolling basis and will be in communication if we are able to extend additional aid. If we are unable to meet your request at this time, we will continue to (re)assess our capacity throughout the fall term and keep your request on file, if you would like us too. It is our aim to meet family assistance requests as we’re able to do so.

BAX is committed to offering high-quality and accessible arts programs for all. As such, each term tuition is priced at three tiers, which includes sliding scale subsidies of up to 40% so that each family can assess the price that works best for their household. This is based on an honor system of your-expressed-need (we do not require financial documentation). By paying what you are able, you help us better meet the needs of other families. Click HERE to register with up to 40% subsidy online.

If you are seeking financial assistance beyond 40% tuition subsidy, you will need to fill out this Financial Assistance Inquiry Form.

Registration is taken on a first come, first serve basis. For classes, half of the tuition must be received to secure a spot. For Performance Workshops, a quarter of tuition must be received to secure a spot.

To apply, please complete the online application below.

If you have questions about this application, please contact our Education Assistant, Aviya Hernstadt by email: aviya@bax.org

BAX does not discriminate in its programs or activities on the basis of race, color, national or ethnic origin, ancestry, age, religion or religious creed, disability or handicap, sex or gender, gender identity and/or expression (including a transgender identity), sexual orientation, military or veteran status, genetic information, or any other characteristic.

We stand firm and resolute to defend and support, in perpetuity, all forms of expression that are protected by the First Amendment of the US Constitution.

Check here if you are planning to register at one of the public tier levels, but would like to request a deposit of 25%. Remaining balance will be paid out in installments. **Please note that this will require a follow-up phone call with BAX staff to set up the payment plan**

Yes, I would like to register at a public tier level with a 25% deposit

Please specify the level of assistance you are hoping to receive. You can note this through a subsidy percentage or an ideal tuition price. *

If you are requesting a subsidy and we do not reach out to you with a financial assistance offer by the start of the term on January 4th, would you like us to keep your request on file should more aid become available throughout the term? If you are requesting just a reduced deposit, we will reach out to schedule a time to process your registration by phone. *

Yes, keep my request No, do not keep my request on file I am just applying for a reduced deposit

Are you inquiring about financial assistance for a Performance Workshop? (DPW I, II, III, or AcroBAX I or II) *

Yes No

Please select the Performance Workshop for which you would like financial assistance:

DPW I DPW II DPW III AcroBAX I AcroBAX II

The BAX Education Department will work within its capacity to create a payment structure that works for your family. If you need a customized payment plan, please reach out to Aviya Hernstadt at @aviya@bax.org.

*Please note that our registration software, Active, uses automatic billing. If we are able to offer aid, we will work with you to determine a payment plan for your family, and once you are registered, your account will be billed automatically. If you expect that you will not be able to make a payment, please contact Aviya (aviya@bax.org) before that payment date.

I understand that if I accept a financial aid offer, I will be billed automatically at each pay period, and that if I am unable to make a payment on time, I must contact BAX ahead of the payment date at aviya@bax.org. *

III. Enrollment Information

Please list information for each child in your family for whom you would like to register with financial assistance. BAX cannot guarantee that we will be able to offer aid, and we encourage you to reach out directly with questions and/or concerns.

Child 1 Name *

First Name Last Name

Child 1: Preferred Pronouns (How would you like us to refer to you when we are not using your name?)

He/Him/His Just use my name! She/Her/Hers They/Them/Theirs I have different pronouns than these:

Child 1: Gender Expression or Identity

Child 1: Date of Birth

Month Day Year

Child 1 Grade *

Child 1: Please list the class(es) for which you are inquiring about financial assistance. *

Do you wish to apply for Financial Assistance for additional children?

Yes No

Child 2: Name

First Name Last Name

Child 2: Preferred Pronouns (How would you like us to refer to you when we are not using your name?)

He/Him/His Just use my name! She/Her/Hers They/Them/Theirs I have different pronouns than these:

Child 2: Gender Expression or Identity

Child 2: Date of Birth

Month Day Year

Child 2: Grade

Child 2: Please list the class(es) for which you are inquiring about financial assistance.

Do you wish to apply for financial assistance for additional children?

Yes No

Child 3: Name

First Name Last Name

Child 3: Preferred Pronouns (How would you like us to refer to you when we are not using your name?)

He/Him/His Just use my name! She/Her/Hers They/Them/Theirs I have different pronouns than these:

Child 3: Gender Expression or Identity

Child 3: Date of Birth

Month Day Year

Child 3: Grade

Child 3: Please list the class(es) for which you are inquiring about financial assistance.

Please list the email addresses and phone numbers of each child you are registering (if applicable).

Please share any information with regards to accommodations, supports, and/or modifications that will help BAX staff best serve your child(ren). Our teachers are experienced working with children with a variety of physical, cognitive, sensory, and socio/emotional needs and we are committed to collaborating with you to make our programs as accessible as possible. Please be as specific as you can be so that we can provide individualized and personal support for your child(ren) so that they will thrive in this program.

List any support needs, and/or considerations as outlined above (This information will be kept confidential among BAX staff and will be used to determine our program capacity and ensure a safe and quality program experience for your child).

I understand and agree that my Child may be photographed and/or videotaped by BAX or its Representatives exclusively for internal and/or promotional use. I hereby give my consent to BAX to use my Child’s photograph or likeness in a brochure, website or any other promotional materials. These images/photographs and/or videos may appear in various BAX publications, including, but not limited to, publications, teacher resources, advertisements, social media, and websites. Students will never be identified in any way – by name, address, or city.

Yes, I give consent No, I do not give consent

How did you hear about BAX?

IV. Family Information

Please include as much information as possible about all of these students’ parents or guardians. Where applicable, please feel free to list grandparents, stepparents, or other guardians. We are looking to learn more about the students’ entire family support network.

Primary Parent/Guardian

This person will be BAX’s primary family contact. If you would like BAX to be in communication with other parents or guardians, please indicate below.

Name *

First Name Last Name

Phone Number *

Area Code Phone Number

E-mail *

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Please include any additional information about this parent/guardian e.g. Does not provide financial support, will pick student up from class, parents separated, legal guardian, foster agency, etc.

Demographic Information

The following information helps us to understand the breadth of our BAX community and supports our commitment to equity building. If you have any questions about this section, please feel free to email lucia@bax.org.

Primary Language(s) Spoken at Home:

Which of the following best represents the family's racial identity? Please select all that apply.

Arab or Middle Eastern Asian or Asian American or Pacific Islander Black or African American Native American or Alaskan Native Latinx White or European Something not listed above

What is your Annual Household Income?

Under $15,000 $15,000 to $24,999 $25,000 to $49,999 $50,000 to $74,999 $75,000 to $99,999 $100,000 to $124,999 $125,000 to $149,999 $150,000 to $199,999 $200,000 and Above

V. General Financial Information

This information is for office use only and is kept strictly confidential. The more information you are able to provide, the better we can assess your need for financial assistance. On this page, we are looking to learn more about the financial resources available to the student(s). Please list only parents or guardians who provide financial support to the student(s).

Parent/Guardian #1

Place of Employment *

Work Phone Number

Area Code Phone Number

Salary *

*

Yearly Monthly Weekly Other (please describe below):

Would you like to add the financial details of another parent/guardian?

Yes No

Parent/Guardian #2

Place of Employment

Work Phone Number

Area Code Phone Number

Salary

Yearly Monthly Weekly Other (please describe below):

Please describe any other sources of income or aid: e.g. Medicaid, food stamps, child support, financial assistance from other organizations, etc.

Including the student(s), how many children or dependents are supported by these adults? e.g. other children, full-time students, dependent parents, etc. *

What other activities do(es) your child(ren) participate in outside of school? Please note whether these activities charge tuition, are free of charge, or are offering you financial assistance. *

How much do you typically spend on these activities? *

Per year Per semester Per month

Please detail any other factors, including, but not limited to, disruption in your family's finances due to COVID-19, that contribute to your financial need at this time:

I understand that the completion of this application does not guarantee a financial assistance offer, and that BAX will be in touch if an award will be made for Fall 2020: *

Initial

Parent/Guardian Signature: *

Clear