Fill out the form and submit electronically or download a PDF form here.
Total number of dependents (including parent/guardian) in family household
TOTAL household income BEFORE deductions: include income of all working household members, welfare payments, pensions, child support, Social Security, and any other income.
THE FIRST TWO PAGES OF YOUR 2017 FEDERAL INCOME TAX RETURN, COPY of W-2's or OTHER PROOF OF INCOME MUST BE INCLUDED WITH THIS APPLICATION. INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please use a separate sheet of paper for any additional information you feel may be important in considering your application.
Healthy Smiles (3rd grade)
February 25, 2020
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Crazy 8s Math Club
February 25, 2020 4:45 pm - 5:30 pm