Family School Support Screening Application

Family School Support Screening Application

Completing this form is step one of a three step process. Step one is the screening process. Step 2 is reference and background check. Step 3 is confirmation of details of the project. The NTICE Foundation Board will review applications that have completed all three steps.
Name of the school your child is attending:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Description of hardship of student(s) and why this grant will help.*
Less than 1000 words
Upload 2-3 pictures of the school:*

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Anticipated date of needed funds:*

YearMonthDay
Applications are reviewed semi annually: July an December with recipients receiving notice in September and in February.
Requested NTICE Grant amount:*
Limit $300 per child
List items that are needed and dollar amounts:
1.   Type a label   $
2.   Type a label   $
3.   Type a label   $
Submit (upload) a brief letter (less than 300 words) from a teacher or administrator for recommendation and affirming student financial hardship.*

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Name of teacher or administrator of school confirming need:*
Email address of teacher or administrator:*
example@example.com
Student(s) parent's name:*

First NameLast Name
Name(s) of student(s)
First Name   Last Name
First Name   Last Name
First Name   Last Name
First Name   Last Name
First Name   Last Name
First Name   Last Name
Parent email:*
example@example.com
Parent Phone Number:*
Please enter a valid phone number.
Reference Check Information
Teacher of the School
Name:*

First NameLast Name
Email:*
example@example.com
Administrator of the School
Name:*

First NameLast Name
Email:*
example@example.com
** Contact will be made with parent(s) and school personnel.
Should be Empty:

Family School Support Screening Application

Reference Check Information