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2021 Momentum Summer Catalyst Scholarship
Please fill out the following form to apply for a Summer Catalyst Scholarship. Scholarships apply to Momentum programs being offered June 21 through July 30, 2021.
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* Indicates required question
Email
*
Your email
Parent Name
*
Your answer
Student Name
*
Your answer
Preferred Service - Check all that apply
*
Trained Private Aide
Certificated Teacher
Catalyst Challenge Camp
Online
In-Person
Required
Summer Goals for Student - Check all that apply.
*
Build academic skills
Boost confidence
Expand knowledge
Social interaction
Structured days
Opportunity to experiment and create
Consistency
Other:
Required
In the past 12 months have you experienced any of the following? Check all that apply.
*
Illness or injury in family
Loss of income
Divorce
Death in family
Military deployment
Siblings in tutoring
Household yearly income below $60,000
Paid for six months or more of Momentum Services
Student IEP or 504
Issues with remote learning
Other:
Required
Scholarship Request
*
10% off tuition
25% off tuition
50% off tuition
75% off tuition
Other:
Required
Send me a copy of my responses.
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