I certify that the above information is true and complete to the best of my knowledge, and that I do not have additional income not represented above. I agree, if necessary, to send additional information and documentation to support the above statements. I understand that if I falsify any of the above information, I will not be eligible for assistance now and/or in the future.
For eligibility purposes, we must receive proof of financial assistance. Please provide one of the following: government assistance (i.e. government insurance, food stamp card, if your child receives free or reduced lunch), a recent pay stub or a recent tax return.
NOTE: Please make sure your files are named clearly so we can process your application quickly.