2026-2027 Application

2026-2027

Financial Assistance Application

Use this form to apply for financial assistance by completing all required sections. Incomplete applications will not be accepted. Please don't forget to upload your photo ID as well as proof of your household income. If you are not using your tax return, then please upload the letter you received to begin receiving services or proof of claim if you are using one of the other qualification methods. If you have any questions, please send email to FAQuestions@drd.us.com.
Financial Assistance Application Form

Valid from July 1, 2026 - June 30, 2027
Section 1: Applicant Information
Name (Please print)
Address
City, State, ZIP
Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Section 2: Household & Income Information
Family Size
Family Income (current yearly income from all sources)
Section 3: Income Verification
Income Verification - Document Type (select all that apply)
Section 4: Applicant Certification
I certify that the information on this form is accurate and complete and understand it may be subject to verification. I have attached proof of my eligibility.
Applicant Signature
Signature Date

MonthDayYear
Date
Section 5: Individuals to Receive Assistance
Individuals to Receive Assistance (up to 5)
Section 6: Approval Notification Contact

This is the information we will use to let you know your application is approved - look for award letter by email
Adult/Parent Name (Please print)
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
File Upload - upload all documents you checked above (Photo ID plus income verification documents)

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2026-2027

Financial Assistance Application

Financial Assistance Application Form

Section 1: Applicant Information

Section 2: Household & Income Information

Section 3: Income Verification

Section 4: Applicant Certification

Section 5: Individuals to Receive Assistance

Section 6: Approval Notification Contact