Request Financial Assistance
Please fill out this form to request financial support for your child's band participation fees. Select your preferred assistance option and provide the necessary details. We have a limited amount of funds that can be used for financial assistance. All responses here are strictly confidential and are not shared with any other parents or Booster members.
Parent's Full Name
*
First Name
Last Name
Student's Full Name
*
First Name
Last Name
Parent's Email Address
*
example@example.com
Type of Assistance Request
*
Payment Plan - I need more time to pay off my balance.
Financial Assistance - I am requesting financial assistance to help pay for my band participation fees. I understand that unless otherwise stated, the Boosters will match funds received from cash payments and fundraising profits on a dollar-‐for-‐dollar basis up to the amount I am requesting.
Payment Plan only - How much would you like to pay monthly? Please indicate your Payment Plan Monthly Amount ($) below.
Payment Plan only - When do you anticipate the balance being paid off?
-
Month
-
Day
Year
Date
Financial Assistance Only - Please indicate your Requested Assistance Amount ($) below. A maximum of 50% of total fees will be granted (boosters or fundraising $ will be used to match the remaining 50%).
Signature
Submit Request
Should be Empty: