#areuin? Card Application
We are proud to offer students full scholarships and/or reduced pricing for certain programs and activities offered in our region.
Which application will you be applying with?
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Please Select
Free / Reduced Lunch
Medicaid
Validator
Student Information
Student Name
*
First Name
Last Name
Student Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School District
*
Please Select
SAU 16
SAU 21
SAU 50
SAU 52
SAU 90
School Name
*
Current Grade
*
Birth Date
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-
Month
-
Day
Year
Date
Gender
*
Please Select
Male
Female
Transgender
Non-Binary
Prefer not to respond
Race / Ethnicity
*
Please Select
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latin
Native Hawaiian or Other Pacific Islands
White
Prefer not to respond
Parent / Guardian Information
Parent / Guardian Name
*
First Name
Last Name
Parent / Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent / Guardian Email
*
example@example.com
Parent / Guardian Phone Number
*
Please enter a valid phone number.
Please attach a copy/photograph of Student's Reduced Lunch letter.
*
Browse Files
Drag and drop files here
Choose a file
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of
Please attach a copy/photograph of Student's Medicaid card.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please check the boxes below to agree:
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By checking this box, I understand that The KEY Collective/#areuin? card is not a school program. It is a KEY Collective Program.
By checking this box, I agree to let The KEY Collective inform me of other discounts and opportunities available to my child through their program.
How did you hear about us?
*
Please Select
School
Doctor's Office
Social Services
Program Partner
Other
Validator Information
Validator Name
*
First Name
Last Name
Validator Organization
*
Validator Email
*
example@example.com
Validator Phone Number
*
Please enter a valid phone number.
Address
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