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DASA Scholarship Request From
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* Indicates required question
Student Name
*
Your answer
Student grade and home room
*
Your answer
Parent Name
*
Your answer
Parent email address
*
Your answer
Do your family currently qualify for any of the following programs?
*
Resident in Brookline Public Housing
Section 8/Housing
SNAP/Food Stamps
Free lunch program
TAFDC/EAEDC
MassHealth/CHIP
Award letter from PSB for free or reduced programs
Other:
Required
I attest that I will email approval documents for programs above to DASA email address: Driscolafterschool@gmail.com
*
Yes
No
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