HPISD Summer School Financial Assistance Request Form (Summer 2024)

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HPISD offers partial financial assistance to those students in need. The HPISD Summer School application is in-depth and requires supporting documentation. It is important to understand that financial aid is reviewed each summer by the financial assistance committee. The financial assistance committee is comprised of an administrator, a counselor and a teacher. No applications will be considered without supplying ALL supporting documentation listed below.

Students with outstanding balances from a previous summer are not eligible for assistance.

Financial assistance eligibility:
1. You must be willing to discuss personal financial matters with a member of the financial assistance committee, if requested.
2. You understand that you will be responsible for paying the balance that is not covered by the financial assistance committee.
3. Student must be in compliance with the summer school attendance policy.

SUMMER Financial assistance request form due date is May 31st. The form must be received by 4:00 pm on the last day of school for it to be reviewed.

To apply for financial assistance, please complete the HPISD meal assistance application found on the HPISD website - https://www.hpisd.org/apps/pages/index.jsp?uREC_ID=938438&type=d&pREC_ID=1713042

Additionally, please complete this form specific to HPHS Summer School. All information will be considered in determining the level of financial assistance that will be provided.
1. Completed Financial Assistance Request Form
2. Any other documentation that might help the committee understand your need, please email to redmane@hpisd.org.

All information provided will be kept confidential.

Email *

Student Name *

Grade Level (2023-2024 school year) *

9th

10th

11th

12th

Date of birth of Student *

YYYY

Phone Number of Student *

Street Address, City, State, Zip of Student *

Name of Parent/Guardian Submitting Application *

Phone Number of Parent/Guardian *

Email Address of Parent/ Guardian *

Assistance Request: _______% of summer school fees (each semester course: $400-$450) *

Total Household Income (all sources, prior to taxes) $__________ & Monthly /Annual (Pick one) *

Is anyone in the household receiving the following assistance? (pick what apply) *

Medicaid/ Medicare

Food Stamps

Child Support

Lunch Program

Unemployment

NONE

Required

Briefly, describe the circumstances that require financial assistance for the student to participate *

Please list courses your student would like to enroll in this summer. *

Information about other children in the home (name, age, relation to the student). Please list: *

I hereby certify that the information I have provided is true and correct as of this date, to the best of my/our knowledge. I understand that any discrepancies found may result in termination of any financial aid and ineligibility for future assistance. *

Yes

Enter Electronic Signature *

Today's Date *

YYYY

A copy of your responses will be emailed to the address you provided.

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