Request for Tuition Assistance

Request for Tuition Assistance
Family Information

Please fill out this section completely.
Child's Name

First NameLast Name
Date of Birth

DayMonthYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
School/Child Care Center
Parent/Guardian Name

First NameLast Name
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you or your children eligible for any programs such as Medicaid, TANF, Yes Waiver program, or other sources of support?

YesNo
Is this child a foster child?

YesNo
Your Story

Your story—whether it's about you and your family, the people you know, or an entire community—has the potential to motivate others with real-life tales of how Dance and Gymnastics help promote healthy choices, self-esteem, and positive outcomes for children. Please take a moment to express how Kinderdance® and Fitness Hill Country has the potential to help you and your family through the programs it offers. List any challenges you feel we should take into consideration when reviewing your application.
Your Story
Additional Information
- Some evidence of financial need will be required prior to finalizing any tuition assistance applied.
- Regular attendance in classes is expected. We often have waiting lists and want to make class spots available to children most interested.
- Financial assistance is offered for the term indicated when awarded. Assistance beyond that term is not guaranteed.
Signatures
I affirm that the information in this for is true and accurate according to my knowledge.
Date

DayMonthYear
Guardian/Parent(s) Signature
Should be Empty:

Request for Tuition Assistance

Family Information

Your Story

Additional Information

Signatures