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JCC SoCo
Preschool

License #: 493010450

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JCC SoCo Preschool

Tuition Assistance Application

For what year are you applying for tuition assistance?

Current School Year

Summer Program

Next School Year

Preferred Schedule (Days & Times)

Primary Parent/Guardian

First Name

Last name

Relationship to Child

Phone

Home Address

Occupation & Company Name

Employment Status

Full Time

Part Time

Not Currently Employed

Additional Parent/Guardian

First Name

Last name

Relationship to Child

Phone

Home Address (if different than child)

Occupation & Company Name

Employment Status

Full Time

Part Time

Not Currently Employed

Child's Information

First name

Last name

Primary Household Address

City, State, Zip

Child's Birthday

Month

Day

Year

Does your child have a disability or do you have any concerns about your child's development?

Yes

Maybe

Primary Language at Home*

Financial

Annual Household Income*

Number of members in the household. (Please specify ages and relationship to student)*

Is your family receiving cash benefits or other services TANF, SSI, WIC, CalFresh, CalWorks?

Yes

Is at least one parent/guardian an active duty member of the United States military?

Yes

Is at least one parent/guardian a veteran of the United States military?

Yes

Requested Tuition Assistance Percentage

More Information

Is there anything else you want us to know about your family or your extenuating circumstances? / Why are you requesting a tuition assistance?