#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?
*
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 (Exeter School District)
SAU 21 (Seabrook School District)
SAU 50 (Portsmouth Area School District)
SAU 52 (Portsmouth School District)
SAU 90 (Hampton School District)
We DO NOT ACCEPT applications from any school districts not listed in the drop down.
School Name
*
Current Grade
*
Birth Date
*
-
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.
Format: (000) 000-0000.
Please attach a copy/photograph of Student's Reduced Lunch letter.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
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:
*
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.
Format: (000) 000-0000.
Address
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