Community Change Jars - Student Application

Community Change Jars Student Application

We are excited to receive applications from students eager to earn their first savings account with the support of their community! Students may apply independently or have their parents, guardians, teachers, or leaders apply on their behalf by completing this form. While we encourage all interested students to apply, not every application will be selected due to limited resources—email programs@8cents.org for additional inquiries.
Student Information

Make sure your coin stash is sorted, whether it's you or your folks applying.
Student's Name:*

First NameLast Name
Student's Email Address:*
An email address you would check to claim your prize. Not your school email address though.
Student's Date of Birth:*

MonthDayYear
Student's Age:
Student's Home Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Student's Zip Code:*
Primary Language:*
Student's Gender Identity:*
Student's Identified Ethnicity or Race:*

American Indian or Alaska NativeAsian or Asian AmericanBlack or African AmericanHispanic or Latino or Spanish OriginNative Hawaiian or Other Pacific IslanderWhite or CaucasianOther
Do you or anyone in your household qualify for a federal program?*
such as Medicaid, SSI, SNAP, Free or Reduced Lunch, TANF, WIC?
What is your current high school or school classification?*
If enrolling in the summer months, use the grade level and school you will attend.
What is your current grade level?*
Grade level for the current school year. If enrolling in the summer months, use the grade level you will be in.
Are you currently receiving any financial literacy education?*
Do you (the student) have an active savings account in your name?*
Please enter the amount in the savings account:
If selected, what would you like to save for?

0/250
Parent/Guardian Information

They deserve coins too! Should the parent or guardian not be present at the time of enrollment, we will use the email address given on this form to automatically reach out and email the necessary consent forms.
Parent Name*

First NameLast Name
Parent Email Address:*
i.e.., badmamajama@gmail.com
Parent Phone Number:*
Please enter a valid phone number.
Emergency Contact Name:
Add a name here if the emergency contact is not the parent or guardian listed on the form.
Emergency Contact Phone:
Add a number here if the emergency contact is not the parent or guardian listed on the form.
Some Really Important Stuff

This will make our partners, accountants, and legal friends really happy.
The 8 Cents in a Jar program is committed to student enrichment through financial education and rewards. As the student and parent/guardian, you provide consent for your student to engage in learning about saving money, acquiring assets, and building wealth through the program. Our program will take place year-round, with optional weekend activities. Here’s what you need to know:

Rewards and Earnings:
- The program offers students the chance to earn cash prizes and donated stocks as a reward for their participation.
- If your child earns over $600, 8 Cents in a Jar will send a 1099 form for tax purposes.
- While the program aims to educate students and set specific outcomes, results are not guaranteed. Past cumulative success does not guarantee the future success of each student.
- You agree to discuss your student’s financial goals and their future implications.
Educational Platforms:
- The program may utilize online platforms like Mighty Networks, Google Classroom, and Microsoft Classes to deliver content and facilitate interactions.
- You agree to review these platforms’ privacy policies and terms of use before allowing your child to access them.
Media Release:
- As a parent or guardian, you grant 8 Cents in a Jar all rights to photographs, images, video, or audio recordings of the student made in connection with the program.
- This includes any royalties, proceeds, or other benefits derived from such media.
Liability and Risk Evaluation:
- You acknowledge that the program is not liable for any bodily injury, personal injury, illness, death, or property damage that may occur during program activities.
  By participating, you and your child assume the risks associated with these activities.
- You acknowledge that the program may include games, simulations, discussions, surveys, and quizzes that may collect personal information from your child, such as their name, age, financial goals, opinions, and feedback.
- 8 Cents in a Jar is a 501c3 nonprofit organization focused on financial education. Members of 8 Cents in a Jar (including volunteers, collaborators, or board members) do not provide financial advice under any circumstances.
- Personal information such as name, date of birth, financial goals, and email address is collected to improve our programs and services.
- For specific programs, some funders (State of Florida, Orange County Government, National Endowment for Financial Education) will confirm services are being provided during program evaluations and audit monitoring.
- 8 Cents in a Jar adheres to the privacy and record retention guidelines for minors as stipulated by Florida statute 943.0515.
By signing this document, you acknowledge and agree to the abovementioned terms, ensuring a clear understanding of the program’s structure and your child’s involvement.
Student Signature to join the program:*

Clear
I hereby declare that I understand and intend to learn about personal finance from 8 Cents in a Jar. I acknowledge that I have willingly and voluntarily agreed to waive any liability for this learning experience. I confirm that I am of legal age to consent, and if I am not, I have obtained permission from my parents or guardians, as indicated by their signatures. I allow 8 Cents in a Jar to share my application information with Orange County, City of Orlando, or other organizations if required for my services. Shared information will be limited to what's essential for my plan.
Parent Signature to join the program:*

Clear
I hereby declare that I understand and intend to learn about personal finance from 8 Cents in a Jar. I acknowledge that I have willingly and voluntarily agreed to waive any liability for this learning experience. I confirm that I am of legal age to consent, and if I am not, I have obtained permission from my parents or guardians, as indicated by their signatures. I allow 8 Cents in a Jar to share my application information with Orange County, City of Orlando, or other organizations if required for my services. Shared information will be limited to what's essential for my plan.
Signature Date:

MonthDayYear
Date
Just making sure you read the paragraphs above*

I consent to 8 Cents in a Jar waivers and the abovementioned terms, ensuring a clear understanding of the program’s student involvement and my responsibility as a parent.
Project__c
Project__c Record ID
Program Cohort__c
Service__c
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Should be Empty:

Community Change Jars Student Application

Student Information

Parent/Guardian Information

Some Really Important Stuff