Sliding Scale Fee Application
Sign in to Google to save your progress. Learn more
Email *
Caregivers Name *
Child's Name (First, Last) *
Phone Number *
Email *
Is your child currently enrolled or have they ever been enrolled in our program? *
How many dependents are living in your household? *
Briefly share your goals for your child in regards to participating in our program? *
Please select the locations of interest ( may select more than one) *
Required
Which Tier are you applying for? *
Please describe why you are applying for a sliding scale membership and what impact it would have on your family *
What is your estimated annual income? *
What is your approximate monthly budget for group gymnastics classes? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Flip For Function. Report Abuse