Grant Application | Pathways for Children Foundation

Step 1 of 7

Family information

Parent / Guardian 1

First name Last name Email Cell phone

Parent / Guardian 2 optional

First name Last name Email Cell phone

Family address

Street address City State ZIP code

Step 2 of 7

Student and program details

Student first name Student last name Grade School name Program name

School or program contact

Contact person Contact person email Contact person phone

Step 3 of 7

Educational needs

Why is the student enrolled in this program? How was that determination made? What supports is the student currently receiving? optional

Step 4 of 7

Program costs

Monthly program cost Assistance requested

Besides tuition, are there extra fees or expenses? optional Does insurance cover any of the expenses? If so, please explain.

Step 5 of 7

Family financial picture

Monthly household income Housing status Monthly housing expense Do you lease a car or have car payments? Current debt obligation amount Approximate savings and investments

Other unusual circumstances optional

Step 6 of 7

Supporting uploads

Uploads are optional. Accepted file types: PDF, JPG, PNG, DOC, DOCX. Each file may be up to 8 MB, with a combined limit of 20 MB.

Program tuition statement Choose file No file selected School or program letter Choose file No file selected Evaluation or support plan Choose file No file selected Financial documentation Choose file No file selected

Step 7 of 7

Review and submit

Before submitting

Please confirm the information is accurate. The foundation board or review committee will review the request and contact you when a decision or follow-up request is available.

I certify that the information submitted is accurate to the best of my knowledge.