Room 17 Financial Assistance Qualification Form
We know that families may want to offer their children learning opportunities that may not always be possible, given the ups and downs of "life". If you have a child who is interested in our WIN Tutoring or Summer Math Camp and in need of financial assistance, please take a moment to complete this short request.  

We'd love to hear from you! Feel free to share any insights about how your child would benefit from Room 17 services. Whether it's improved problem-solving skills, confidence, or a love for numbers, we're eager to learn.
 
With the help of our community donors and generous sponsorships, we hope to be able to offer a plan that works for your family soon!

Remember, you're not alone. Our financial assistance program is designed with care and compassion. We're committed to making a positive impact on the opportunities for your child through spreading the joy of math through engaging experiences and eliminating math phobia. Lastly, we want to express our heartfelt gratitude. This program is made possible through grant funding and the generosity of individual donors who believe in empowering children with confidence in mathematics.  Thank you for entrusting us with your journey. If you have any questions or need further assistance, please reach out to our dedicated team at team@room17math.com

Assistance will be awarded based on need and availability. It is important to remember that assistance is not guaranteed, but we will do everything we can to accommodate all roomies! 

~Sara and Monica~ Room 17 Math, Inc.

Sign in to Google to save your progress. Learn more
Email *
First and Last Name of Parent/Guardian *
Phone Number *
First and Last Name of Student(s) *
Home Address *
Grade of Student(s) and/or course topic: *
How did you hear about Room 17? *
Are you currently receiving free or reduced-price school lunches for your children?
*
How many adults contribute to your family income? 
*
How many dependents (including your children) are in your household?
Clear selection
Which service option(s) are you interested in (you can find details on our website):  *
Required
Why do you feel your child would benefit from our services? *
Why should you be considered for a financial aid package? If you desire a full or partial sponsorship please indicate, if you are comfortable sharing.
Is there anything else Room 17 should know about your request or child?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of room17math.com. Report Abuse