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Financial Aid Application for Village Theatre KIDSTAGE 2023-2024 Season
Location:
*
Issaquah
Everett
Current Session:
*
Fall
Winter/Spring
Summer
School Year
*
Applying for:
*
Class/Camp
Production
Institute
If applying for a production, please let us know the title.
1. STUDENT INFORMATION
# of Students Applying:
*
1
2
3
4
Student Name
*
First
Last
Student Date of Birth
*
MM
/
DD
/
YYYY
Student #2 Name
First
Last
Student #2 Date of Birth
MM
/
DD
/
YYYY
Student #3 Name
First
Last
Student #3 Date of Birth
MM
/
DD
/
YYYY
Student #4 Name
First
Last
Student #4 Date of Birth
MM
/
DD
/
YYYY
2. PARENT INFORMATION
Primary Parent/Guardian Name
*
First
Last
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Best Contact Phone
*
###
-
###
-
####
Email
*
Other Parent/Guardian Name
First
Last
Address
Street Address
City
State / Province / Region
Postal / Zip Code
Phone
###
-
###
-
####
Email
3. FINANCIAL INFORMATION
If using a free/reduced lunch award as proof of eligibility, please attach here:
If not using a free/reduced lunch award, please complete the following (KIDSTAGE reserves the right to verify income for those who do not participate in free/reduced lunch program):
Number of parent/guardians residing in the household:
Number of dependents residing in the household:
Adjusted Gross Income from most recent tax return:
Please note any extenuating circumstances that might lead to a greater need of financial aid.
By signing this form, you are testifying to your stated household size and adjusted gross income.
Do you understand and agree to the terms listed above?
*
Yes, I understand and agree to the terms listed above.
Signature
*
Clear
Please use your mousepad to sign
