SFYSA 2022-2023 Student Registration - Financial Aid Application

Health and Medical Information

Please input "N/A" for any field that does not apply to this student.
Emergency Contact: Parents cannot be emergency contact*

First NameLast Name
Emergency Contact Relationship to Student*
Emergency Contact Phone*
Please enter a valid phone number.
Student Food Allergies
Student Medicinal Allergies
Other Allergies
Medical Alerts/Notices
Doctor's Name*

First NameLast Name
Doctor's Phone*
Please enter a valid phone number.
Health Insurance Provider*
Group Number*
Member Number
Volunteering
Family Volunteer Requirements*
SFYSA strives to provide the highest quality music education at an affordable rate. However, tuition covers 33% of costs and SFYSA depends on the service of families to assist with necessary fundraisers, concerts and other special events.We require each family to provide 5 hours of volunteer service during the season. There are many activities that take place, so there is something for everyone! We appreciate your help.Please select yes to show that you understand.
Volunteering Interest
Release and Waivers
Permission to Participate*
As the parent/Guardian, I hereby give permission for this student to participate in the programs and activities of the Santa Fe Youth Symphony Association including rehearsals, performances, tours, retreats, and fundraising activities. I certify my understanding that, as a result of the current ongoing Coronavirus (COVID-19) pandemic, participation in face-to-face gatherings of any kind, and specifically gatherings in which playing instruments are involved, participation is potentially hazardous to my and/or my student's health. I hereby release SFYSA from any and all claims, damages, or other liabilities which may be asserted as a result of the students participation in the activity, or any injury, loss, damage, or incident occurring during such participation.
Health/Emergency Consent*
I agree that the Santa Fe Youth Symphony Association may obtain medical attention, advice, evaluation, or treatment for my child in an emergency while participating in SFYSA events. In case of emergency, I understand that reasonable efforts will be made by SFYSA to contact me. In the event of an emergency, I agree to pay for any medical services that might be needed beyond that provided by my insurance. I hereby give my permission for the administration of over-the-counter medications by a SFYSA staff member. I agree and understand that the Santa Fe Youth Symphony Association has sole discretion to determine when such an emergency has occurred.
Parent/Guardian Obligations*
As a parent/guardian of a SFYSA member, I realize my obligation to the SFYSA and my student member. I will keep current with my financial and service obligations. I will make sure that my student's SFYSA schedule is followed and that he/she is a contributing member of the organization. I further understand that excessive absences and tardies, inappropriate behavior, and unfulfilled obligations both musical and financial will be cause for dismissal from the SFYSA. I will pay for damage to music or property, if any that occurs is a result of my student's behavior. As a parent of a student in this ensemble, I agree to have my student(s) at the dress rehearsals and performances.
Financial Commitment*
Please check the box to indicate your understanding that you are assuming a financial obligation and that you are solely responsible for making sure tuition is paid.
Image and Video Release*
As part of our outreach and funding reports we may take photographs and vidoes of our children in action as they participate in classes, rehearsals, fundraisers, and concerts. We also post images and video on our website and social media. Please indicate if you give your consent for us to use your child's image for these purposes.

Financial Aid Application
Requested Financial Aid level *
Please request level of financial aid you qualify for based on your proof of income.
Tuition Payment Plans

The Santa Fe Youth Symphony Association offers families two unique ways to pay for tuition:
- Payment in Full (1 payment in total for semester)
  Full payment will be charged on January 15th, 2023
- Payment by Month (3 payments in total - each payment is 1/3rd of the total cost)
  1st payment will be charged on January 15th. Remaining payments will be charged on the 15th of February and March.
With these payment options in mind, please select the payment option that works best for your family. Once a payment plan is selected, families will not be able to change their selection:
I anticipate paying tuition *
First page of most recent tax return(s) - Student for whom assistance is sought MUST be listed as a “Dependent” on line 6c of the included 1040 or 1040A. In situations of joint custody, both parents’ incomes must be reported.*

function SvgDhtupload2(props) { return /* @__PURE__ */ react.createElement("svg", dhtupload_svg_extends({ width: 54, height: 47, xmlns: "http://www.w3.org/2000/svg" }, props), dhtupload_svg_path || (dhtupload_svg_path = /* @__PURE__ */ react.createElement("path", { d: "M40.213 10.172c1.897.21 3.68.738 5.35 1.58a15.748 15.748 0 0 1 4.374 3.242 15.065 15.065 0 0 1 2.951 4.533c.72 1.704 1.08 3.522 1.08 5.455 0 1.827-.28 3.654-.843 5.48-.562 1.828-1.379 3.47-2.45 4.929A13.39 13.39 0 0 1 46.669 39c-1.599.948-3.452 1.458-5.56 1.528H37.26a1.62 1.62 0 0 1-1.185-.5 1.62 1.62 0 0 1-.501-1.186c0-.457.167-.852.5-1.186.334-.334.73-.5 1.186-.5h3.848c1.44 0 2.75-.37 3.926-1.108a10.851 10.851 0 0 0 3.03-2.846 13.53 13.53 0 0 0 1.95-3.9 14.23 14.23 0 0 0 .686-4.321c0-1.582-.316-3.066-.949-4.454a11.623 11.623 0 0 0-2.582-3.636 12.857 12.857 0 0 0-3.742-2.478 11.054 11.054 0 0 0-4.48-.922l-1.212-.053-.37-1.159c-.878-2.81-2.292-4.998-4.242-6.562-1.95-1.563-4.594-2.345-7.932-2.345-2.108 0-4.005.36-5.692 1.08-1.686.72-3.136 1.722-4.348 3.005-1.212 1.282-2.143 2.81-2.793 4.585-.65 1.774-.975 3.68-.975 5.718h.053l.105 1.581-1.528.264c-1.863.316-3.444 1.317-4.744 3.004-1.3 1.686-1.95 3.584-1.95 5.692 0 2.39.8 4.462 2.398 6.219 1.599 1.757 3.488 2.635 5.666 2.635h4.849c.492 0 .896.167 1.212.5.316.335.474.73.474 1.187 0 .456-.158.852-.474 1.185-.316.334-.72.501-1.212.501h-4.849a10.08 10.08 0 0 1-4.374-.975 11.673 11.673 0 0 1-3.61-2.661 13.173 13.173 0 0 1-2.478-3.9A12.073 12.073 0 0 1 0 28.301c0-2.706.755-5.148 2.266-7.326 1.511-2.178 3.444-3.636 5.798-4.374.14-2.354.658-4.542 1.554-6.562.896-2.02 2.091-3.777 3.584-5.27 1.494-1.494 3.25-2.662 5.27-3.505C20.493.422 22.733 0 25.193 0c1.898 0 3.637.237 5.218.711 1.581.475 3.004 1.151 4.269 2.03a13.518 13.518 0 0 1 3.268 3.215 18.628 18.628 0 0 1 2.266 4.216Zm-11.964 13.44 6.22 6.85c.245.247.368.537.368.87 0 .334-.123.642-.369.923l-.421.263c-.211.246-.484.343-.817.29a1.544 1.544 0 0 1-.87-.448l-3.69-4.11v16.97c0 .492-.166.896-.5 1.212-.334.316-.729.474-1.186.474-.492 0-.896-.158-1.212-.474-.316-.316-.474-.72-.474-1.212V28.25l-3.584 4.005a1.544 1.544 0 0 1-.87.448.959.959 0 0 1-.87-.29l-.42-.264c-.247-.28-.37-.588-.37-.922 0-.334.123-.624.37-.87l6.113-6.746v-.052l.421-.422a.804.804 0 0 1 .396-.29c.158-.053.307-.079.448-.079.175 0 .333.026.474.079.14.053.281.15.422.29l.421.422v.052Z", fill: "none" }))); }

Financial aid application documentation: We understand that there are many extenuating circumstances for your family. Please submit your summary page of 2021 tax form, and share changes or extenuating circumstances below. Please include tax returns for all parties paying tuition.
Cancelof
Please let us know of any extenuating circumstances or information that you would like us to take into account when reviewing your application that may not be apparent on your tax form. If you need a lower level of tuition assistance than what is suggested for your household income, please request it here.
Financial Aid Agreement
To maintain financial aid eligibility, students must maintain
- Excellent attendance and be punctual to all classes
- Show exemplary classroom behavior
- Participate in all performances
- Adhere to the SFYSA handbook for their program
If a student fails to adhere to the Financial Aid Agreement, they may be placed on probation for a period of one semester. If the agreement is not upheld during the probationary period, the student may become ineligible for financial aid in future seasons.
Signature*

Clear
By selecting "I agree" and by signing this form, I agree to the "Financial Aid Agreement" outlined in this application.*

I agree

This year, we will have a t-shirt with the season theme, Fire & Ice! Feel free to add a shirt for your student, family members, or anyone who might want one!

*T-shirt sizing (please be aware that "youth" (ex. YS or YM) is the sizing category for children - typical ages are listed below "youth" sizing categories):

T-shirt designed by Julienne Masopust, SFYSA student

My Products

Registration Fee

$5.00

Enter coupon

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Signature*

Clear
By selecting "I agree" below and by signing this form, I agree for SFYSA to charge my credit card for the amount listed on this form.*

I agree
Next steps:

After filling out this form, you will receive an email within one week letting you know what level of financial aid you have been awarded. This email will include a link confirming your payment plan selection and authorizing your first payment (and possibly future payments depending on your plan selection).

Your registration is not complete until you have made your first payment. If a first payment is not made by January 15, your student will not be enrolled in classes.
Should be Empty:

SFYSA 2022-2023 Student Registration & Financial Aid Application

REGISTRATION & FINANCIAL AID APPLICATION

Please fill out one form for each child that you are registering

Ensemble Selection

Student Information

Student Education Information

Household Information

Health and Medical Information

Volunteering

Release and Waivers

Financial Aid Application

Financial Aid Agreement