Henry's Rebellion Tuition Assistance Application

*All applications are reviewed, approved, or disapproved by Henry's Rebellion's board members. The board members hold the right to approve or disapprove applications based on any reason they see fit.

Tuition assistance is awarded based on demonstrated financial need and the availability of funds. Each application is carefully reviewed to ensure support is given to families who need it most, but please note that submitting an application does not guarantee assistance. Awards are distributed as fairly as possible within the limits of the co-op’s current funding.

Today's Date

Month

Day

Year

First name

Last name

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone

Occupation

Spouse Occupation if applicable

Household Annual Income

Number of Children in the Household

Seeking Sponsorship for (Select All that Apply)

Annual Registration Fee

Semester Event(s)

Semester Tuition Fee

Reason for Seeking Financial Assistance

Applicant's Signature

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