Scholarship request College Admissions support group Parent, Guardian, Caretaker's Name * First Name Last Name Student's Name * First Name Last Name Parent/Guardian/Caretaker Contact Email * Student Email * Affirmation of Consent I am either the caretaker/guardian for the student seeking tutoring services or have the consent of my caretaker/guardian to complete this form I am the guardian/caretaker I have consent of my guardian/caretaker Parent/Guardian/Caretaker Phone Number * (###) ### #### PLEASE READ THIS IN FULL: When I went into business, I made a commitment to provide parents affordable options. I can only maintain this commitment with the support. I ask that you use this form with integrity and honesty. If you cannot afford to pay the fixed rate of $300 per month please do not hesitate to use this form. While I have financial commitments, I know there are others who also have financial hardships. I understand hardships. I lost my entire business during the pandemic. In March 2020, within 2 weeks, I went from a stable and healthy business to making $0. My business has not recovered completely. As someone who went and is going through this myself and is still recovering, I want to support anyone who is facing financial hardships as well. WE ARE IN THIS TOGETHER, I GOT YOUR BACK. I want to accommodate those in that situation and I am looking forward to being of service. However, if you can afford to pay $300 a month but would rather pay less then we ask that you reconsider using this form. We expect those who have the capacity to pay and others who cannot pay to use this form to find a price they can afford. Do you understand? * Yes No Are you currently eligible for Government Assistance? If so use the space below to inform us of the assistance you qualify for at this time. If not, please say "N/A" * Have you completed your FAFSA? If so, is your Expected Family Contribution (EFC) $10,000 or less? If you have not completed your FAFSA please type "FAFSA not completed at this time." * Are you eligible for a Pell Grant under your FAFSA? * Yes No FAFSA not completed at this time Are there any other financial circumstances you would like for us to consider Are you looking for a full scholarship or partial scholarship * Full Scholarship (paying $0 per month) Partial Scholarship If you choose partial scholarship, how much would you like to pay per month Of Note: In order to assist with Financial Aid Appeals, where we attempt to negotiate additional tuition/fees discounts for students, everyone in the Admissions Support Group must be willing to provide information about their financial situation. This will include the Expected Family Contribution on the FAFSA (EFC) and/or information/proof about government assistance and/or financial hardships. We collect this information from EVERY group member from the start so we can immediately negotiate aid when it is time. Parents have saved about $3,000-$20,000 per year through this process. Will you be comfortable providing me and your student with this information so they can negotiate Financial Aid? * Yes No Affirmation I affirm all statements made are true and accurate Yes Requirement to Update I understand that if my financial circumstances change for better or worse to contact Jenn The Tutor to make an adjustment to the pricing agreement Yes Thank you!