COVID Relief - Financial Assistance Application
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Email
Email Type
Please select...
Personal
Work
Family Email
Parent/Guardian Phone
Phone Type
Please select...
Mobile
Home
Office
Child's First Name
Child's Last Name
From your latest tax return, please list your household adjusted gross income:
If you are a split household, please list Parent #2 adjusted gross income
Please explain how the COVID-19 pandemic has financially impacted your family
What is your current monthly household income post COVID-19
If you are a split household, please list parent #2 income post COVID-19
What is your total household monthly expenses(please do not factor in Hillside tuition here)
If you are a split household, please list parent #2 monthly expenses
How much do you feel you can afford monthly for Hillside currently? (please include any extended family support)
Any additional comments
Send to: