Summer Enrichment STEAM Academy Financial Assistance Application
Complete this form to request financial assistance in for Emmanuel's 2021 Summer Enrichment STEAM Academy.

This form should only be completed by the primary custodian and/or person assuming financial responsibility of camp fees and payment.

You will receive notice of your financial award by May 30, 2021. You will be notified by email.
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Email *
Parent Name *
Parent Email Address *
Parent Primary Contact Phone Number *
Parent Secondary Contact Phone Number
How many adults over 18 reside in your home? *
How many children under 18 reside in your home? *
Emmanuel STEAM Academy's weekly rate is $150.00. How much are you able to pay per week, per child? (i.e. $100) *This may not be the amount of your agreement, this answer is for informational purposes only. *
Name of child #1  enrolled in Emmanuel's STEAM Academy. *
Name of child #2  enrolled in Emmanuel's STEAM Academy.
Name of child #3  enrolled in Emmanuel's STEAM Academy.
Name of child #4  enrolled in Emmanuel's STEAM Academy.
Please note any extenuating or special circumstances you'd like us to consider in the evaluation of this request.
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