Taylor GSRP Pre-Screen Information Sheet

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Disclaimer: Completion of this form does not guarantee acceptance to the program. GSRP enrollment is based on income, risk factors and the verification of needed documentation. Parents will be called at a later date to complete the application interview and collect the necessary paperwork. Enrollment is not based on a first come first served basis. Students can not be fully enrolled or accepted into the program until the Governor signs the bill to authorize funding for the GSRP program for the 2021-2022 school year. Preference is given to those students born before September 1st.

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電子郵件 *

Child's Date of Birth *

YYYY

Sex *

Female

Male

Child's Name (First and Last) *

Street Address *

City *

Zip *

Phone Number *

Parent/Guardian Name *

Number of ALL in family (include self, all adults and children you are financially responsible for) *

Gross Income (monthly): If paid weekly or bi-weekly then add amounts together to get monthly amount. If have a yearly tax return, then take AGI and divide by 12. *

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