JCC SoCo Preschool

Tuition Assistance Application

Child's Information

First name

Last name

Primary Household Address

City, State, Zip

Child's Birthday

Month

Day

Year

For what year are you applying fr tuition assistance?

Current School Year

Summer Program

Next School Year

Preferred Schedule (Days & Times)

Primary Family Member #1

First Name

Last name

Relationship to Child

Phone

Home Address (if different)

Occupation & Company Name

Primary Family Member #2

First Name

Last name

Relationship to Child

Phone

Home Address (if different)

Occupation & Company Name

Financial

Requested Tuition Assistance Percentage

More Information

Number of members in the household. (Please specify ages and relationship to student)

Is there anything else you want us to know about your family or your extenuating circumstances?

Why are you requesting a tuition assistance?