registration form - Lawton Elementary School
Transcription
registration form - Lawton Elementary School
Lawton PTA Before and After School Enrichment Programs Winter/Spring 2015 UNICYCLE ● KNITTING ● CIRCUS ARTS/TUMBLING ● CHOIR ● DEBATE IPAD LEGO® ANIMATION ● ZUMBA KIDS ● SONGSTERZ TENNIS ● PIANO KEYBOARDING ● ART ADVENTURES ● WATERCOLOR ● RHYTHMIC GYMNASTICS ● HIP HOP DANCE ● CREATIVE CODING FOR KIDS ● CLAY ART ● WORD MAGIC CREATIVE WRITING As the first session of before and after school enrichment classes will be coming to a close at the end of January/early February, the next registration period will be happening from January 6 - January 23. The Lawton PTA is pleased to continue offering before and after school enrichment programs for our students by providing a wide variety of classes. Complete the attached registration form (one per program per student, please) and return to the Lawton PTA Enrichment program box in the school office. The registration period will be from Jan. 6 - Jan. 23. All registration forms turned in Jan. 6 - 9 will be put into a lottery in order to allow for equal access to the class. All forms turned in after Jan. 9 will be registered on a first come basis. A minimum number of students per program are required in order for each program to run. For more details or questions contact the instructor directly or email program coordinators at lawtonenrichment@gmail.com. Don’t wait, space is limited! IMPORTANT INFORMATION – PLEASE READ CAREFULLY: Scholarship information: Limited scholarships are available. Scholarships are granted per session and not for the whole year in order to be fair to all students who may need a scholarship. In addition, scholarship requests should be for one class only. Please mark the classes in preference of order in the event classes fill up. You will be notified by email if your child received a scholarship before the 1st day of class. If your child received a scholarship for the 1st session, your child will not be 1st priority for a scholarship but you may still apply. Payment & Paperwork: Payment is due at the time the registration form is turned in. Students will not be allowed to show up for classes without payment or paperwork. No exceptions will be made so please do not send your child to class without having turned in payment or having filled out the proper paperwork 100%. Emails or calls for registering your child will not be accepted. Pro-rated fees & Refunds: If you sign your child up for a class after it has already started, it is at the instructor’s discretion to approve a pro-rated fee. The same applies if you withdraw your child from a class after it has started. Some instructors have individual refund policies that will be communicated with you. No refunds will be given by the PTA unless withdrawals are made prior to classes starting or a class has been cancelled. Payment Plans: Payment plans must be approved by the instructor and PTA coordinators. If approved, the program coordinators will work with you to set up a payment plan. If at any time payment is not received, your child will not be able to continue in the class. MONDAY: UNICYCLE - ALL LEVELS Students of all levels are welcome to this class. The expectations for all students are to have a good attitude, strong work ethic, and respect for all members of the class. Unicycling is a wonderful individual activity that teaches discipline and focus for oneself but also teamwork and cooperation with others. Instructor: Cheryl Parks – clparks@seattleschools.org Tuition: $190 - tuition includes t-shirt, snacks, equipment maintenance/replacement, performance, and end of year celebration. Grades: 1st - 5th (Kindergarten can join 2nd session if they are tall enough to reach the pedals) Minimum/Maximum Number: 10 minimum and 30 maximum Dates: Session 2 - Feb. 9 - June 1 (14 weeks) *Date for end of the year performance: Saturday, June 6 Time: 2:50 – 4:00 - Lawton Gym KNITTING Back by popular demand is Lawton’s Knitting Club! All levels of experience welcome. Our students will have lots of fun projects to choose from! Instructors: Lisa Blau & Deana Metteer – lisablau@comcast.net, deanametteer@yahoo.com Tuition: $ 165 per session - tuition includes knitting needles, yarn, and a light snack. Grades: 1-5 Minimum/Maximum Number: 8 minimum and 25 maximum Dates: Session 2 - Feb. 9 - June 1 (14 weeks) Time: 2:50 – 4:00 - Room 107 JR. URBAN FOREST STEWARDS Children are engaged with electronic media (computers, television, games) on average 52 hours a week but typically spend less than 49 minutes outside! Right outside Lawton Elementary’s doors lay an opportunity to increase awareness and appreciation for Seattle’s parks. Have you ever wondered about the tags you see on plants in the park? Been curious what is a native plant and what is non-native plant and wonder why it matters? Do you enjoy being outdoors? Do you love hands-on learning? Would you like to know more about how to keep our park healthy and do this why working and playing outside with friends? Join our after school Urban Junior Forest Steward Program and see Lawton Park in whole new way! Be ready to get muddy and have fun! Instructors: Kassandra Bradberry, ksbradberry@gmail.com and Barbara Downward Tuition: $ 25 per session - tuition includes snack and nature notebook. Kid sized gloves will be available to each student during the class session. Students need to wear appropriate rain gear and boots for each class session. Please contact instructor if your child does not have rain gear Grades: 2 - 5 Minimum/Maximum Number: 4 minimum and 10 maximum Dates: Session 2 - Feb. 9 - June 1 (14 weeks) Time: 2:50 – 4:00 - Lawton Park - will always meet in the Commons first TUESDAY CIRCUS ARTS/TUMBLING Have you ever thought, “My life is like a circus!”? Well, now you can enroll your child in our Circus Arts class and make that come true with your real life circus artist! Students will be exposed to circus arts skills such as tumbling, globe walking, juggling, rope jumping, diablo spinning, hula hooping, wheel walking, unicycling and more! Instructors: Cheryl Parks and Sue Turner - clparks@seattleschools.org, sope@comcast.net Tuition: $210 - tuition includes t-shirt, snacks, equipment maintenance/replacement, performance, and end of year celebration. Grades: K-5 Minimum/Maximum Number: 15 minimum and 45 maximum Dates: Session 2 - Feb. 10 - June 2 (14 weeks) * Date for end of the year performance: Saturday, June 6 Time: 2:50 – 4:30 - Lawton Gym SONGSTERZ – SONGWRITING AND PERFORMANCE OFFERED BY IKHANA ARTS Songsterz is a fun and creative way to build children’s writing and math skills while increasing self-confidence and developing performance skills through songwriting. While exploring the writing process children learn about song structure, rhyme, rhythm, pattern, mood, tone, and melody. We will create a song together as a class and then each child will create an individual original song. Guitar, keyboard and/or percussion will be collaboratively added (no previous instrumental ability required). Each student will receive a digital file of recorded songs and End of Session Performance (and any pictures or video taken). Instructor: Jennifer SavageCrane - sixfootsavage@hotmail.com Tuition: $195 per session - tuition includes a light healthy snack, audio files of songs, and the End of Session performance Grades: K – 5th Minimum/Maximum Number: 8 minimum and 20 maximum Dates: Session 2 - Feb. 10 - June 2 (15 weeks) Time: 2:50 – 4:00 - Staff Lounge DOLPHIN CHOIR – K-2 Come wake up with a song and be ready for the day with a smile on your face. The K-2 Choir will be singing a variety of songs and learning singing techniques in a fun environment. They will perform with the 3-5 Choir in a combined end of year concert. Instructor: Elaine Cooper - emcooper@seattleschools.org Tuition: $170 – tuition includes a small morning snack, choir t-shirt, music and rehearsal CD’s for the Music Revue, concert, and end of year celebration Grades: K-2nd Minimum/Maximum Number: 15 minimum and 45 maximum Dates: Session 2 – Jan. 20 - April 8 (Tuesdays) April 22 - June 3 (Wednesdays - all grades will start meeting on Wednesdays after spring Break Time: 7:30 – 8:30 a.m. – Room 210 *Tentative date for concert is June 4 iPad CLAY ANIMATION: MONSTERZ What do you get when you mix a wolverine, salamander, bird, and a shark? A monster of course! Students will use iPads (provided by C.A.N.) to take animation photos, and edit video and sound. Set, character and story construction will be taught. Lessons seamlessly integrate subjects like math/science and visual/language arts. View the class commercial and over 3,000 student animations at www.cancancancan.com (4 cans). Advanced lessons are now offered in every class. Instructor: Mujale Chesebuka - admin@cancancancan.com Tuition: $232 per session Grades: K - 5 Minimum/Maximum Number: 5 minimum and 30 maximum Dates: Session 2 - Feb. 10 - June 2 (15 weeks) Time: 2:50 – 4:00 – Room 111 WEDNESDAY Watercolor and Art Adventures will not offer classes at the same time. One class will start when the other ends. WATERCOLOR Are you ready to bring out the artist in you by enjoying exploring with watercolors? Learn about color mixing and wet in wet techniques while creating your own masterpieces. Students will produce 3-4 paintings Instructor: Carol McKinney - mckinneycarol@att.net Tuition: $ 65 per session. Grades: K - 5th Minimum/Maximum Number: 5 minimum and 15 maximum Dates: Session 2 - Feb. 11 - March 18 (6 weeks) Time: 2:50 – 4:00 – Teacher’s Lounge ART ADVENTURES A fun, creative class where your child will complete art projects and get experience using a variety of mediums such as acrylic paints, watercolor, ink, photography, textile and other mixed media. Instructor: Laura Van Horne – lvhlee@yahoo.com Tuition: $ 125 per session - all materials and a light snack. Grades: K-5 Minimum/Maximum Number: 10 minimum and 20 maximum Dates: Session 2 - April 1 - May 27 (8 weeks) Time: 2:50 – 4:00 - Room 111 *No class on early release days LAWTON CHOIR – 3-5 If you love to sing and our willing to work hard come join the choir with songs from Broadway and pieces for our NW Choral Showcase in April. From mid-April we will be rehearsing for an end of year performance. All K-5 students who attend AM rehearsals will be performing songs for this performance. Instructor: Elaine Cooper - emcooper@seattleschools.org Tuition: $200 – tuition includes a small morning snack, choir t-shirt, music and rehearsal CD’s for the Music Revue, concert, and end of year celebration Grades: 3rd – 5th Minimum/Maximum Number: 15 minimum and 45 maximum Dates: Session 2 – Wednesdays - Jan. 21 - June 3; Fridays - Jan. 23 - June 5 Time: 7:30 – 8:30 a.m. - Music Room 210 & Commons *Concert Date – April 8th, 6:00 – 8:00 p.m. @ Ballard HS * Tentative end of year concert date – June 4th ZUMBA KIDS - K-5 ZUMBA Kids is an hour of Fun, Dance and Games! Time to let your inner STAR out, Rock the Stage and get Fit all at the same time, all skill levels welcome! • Learn up to 10 different dances, emphasizing contemporary urban styles such as Hip Hop, Reggaeton and Pop all set to a Fun and Energetic playlist! • Create your own Choreography, learn to break down parts of a song, add your moves to music! Perform your routines on stage with your peers! • Rock the Stage, learn stage presence, become a performer! Each week practice songs on stage to get ready for our End of the Year Performance! • Games, games and more games, team build get to know your classmates! Instructor: Amie Schumer, Zumba Instructor and Health Coach - amieswayfitness@me.com Tuition: $ 190 per session. Tuition includes: Sway Fitness Swag, end of session celebration (last class of the session) and nutritious snacks. Grades: K-5 Minimum/Maximum Number: 15 minimum and 35 maximum Dates: Session 2 - Feb. 11 - May 27 (14 weeks) *No classes on early release days *End of year performance TBD Time: 2:50 – 4:00 – Lawton Commons RUN LIKE THE WIND This exciting club returns to inspire the “runner” in your child or you. Running is a wonderful lifetime and family activity. Coach and parent, Kamila Kilayko, is excited to share her love of running with the Lawton community. Participants will meet once a week to learn the basics of running and train for upcoming running events in the Seattle area. What better way to encourage lifetime fitness than through real life activities such as this? This class is unique in that it’s not just for students but parents as well. If a parent would like to help with this class by being as “assistant coach”, the tuition for your child will be half of the regular tuition. Maximum of 5 coaches needed. Instructor: Kamila Kilayko – kkilayko@yahoo.com Tuition: $140 per session - tuition includes training, t-shirt and snacks. Registration fees for each running event will be the responsibility of each participant. The goal is to participate in a minimum of 2 more running events this session. Grades: K-5 Minimum/Maximum Number: 10 minimum and 24 maximum Dates: Session 2 - Feb. 11 - May 27 (13 weeks) *No classes on early release days Time: 2:50 – 4:00 - Lawton Gym, trainings will also take place outside. CREATIVE CODING FOR KIDS Give your child a gift that will last: Get them started on computer coding! Let's face it, kids love computer games. But with today's tools, they can be more than consumers. They can be creators! We teach kids the joy of coding, by helping them make their own customized computer games and animations! At our highly-regarded Creative Coding summer camps, day camps, and after-school programs, over 300 girls and boys all around Seattle have learned to code. Our "games and animations first" curriculum is fun, yet substantive and comprehensive. Your kids will have so much fun, they'll hardly realize how much they're learning. Instructors: Nick Dudley, Natasha Harrington, Alec McGovern - eric@creativecoding4kids.com Tuition: $195 per session Grades: 3-5 Minimum/Maximum Number: 8 minimum and 12 maximum Dates: Session 3 - March 11 - May 13 (8 weeks) *No classes on early release days Time: 2:50 – 5:00 - Computer Lab DEBATE CLUB Debate with your friends and family on topics like Homework, Video Games, PG-13 movies, and Space Exploration! Have fun while learning critical thinking skills, empathy, analysis and public speaking in a relaxed and positive environment. Debate club uses teamwork, research materials and games to help students formulate and present arguments, as well as listen, understand and respond to the arguments of others. Instructors: Julie Fontenot, margot@debateablekids.com Tuition: $195 per session Grades: 4-5 Minimum/Maximum Number: 9 minimum and 12 maximum Dates: Session 2 - Feb. 4 - May 6 (12 weeks) *Debate tournament Saturday, May 16th @ Blaine *No classes on early release days Time: 2:50 – 4:00 - Room 204 THURSDAY CLAY ART Bring your creativity to this class! Students will spend 8 weeks making a variety of creative clay projects, including a cup and plate, a fierce (or friendly) clay monster and a variety of projects of your choice! All work will be fired in the kiln and glazed with colorful, non-toxic pottery glazes. All supplies are included and all clay and glazes are completely non-toxic. Instructor: Jane Meagher - janelmeagher13@gmail.com Tuition: $80 per session (8 week session) Grades: K-5 Minimum/Maximum Number: 10 minimum and 15 maximum Dates: Session 3 – March 12 – May 7 (8 weeks) Time: 2:50 – 4:00 – Staff Lounge WORD MAGIC – CREATIVE WRITING Word Magic is a creative writing class designed to give students a chance to express themselves in a safe and supported environment while they explore their writer’s voice and dive into their imagination! Through writing prompts and exercises we will discover literary devices as we learn about descriptive language and precise word choice. Each class session will end with an opportunity to share our ideas and stories and develop an appreciation for each other’s work. We will choose pieces to revise and edit and the class will culminate with a “Reading” open to parents and friends. Instructor: Jennifer SavageCrane - sixfootsavage@hotmail.com - Jennifer SavageCrane, has a Master’s Degree in Teaching from Seattle University and over 20 years of experience coaching, teaching, and tutoring students ages 3 – 18 Tuition: $195 per session - tuition includes a light healthy snack Grades: 1-5 Minimum/Maximum Number: 10 minimum and 25 maximum Dates: Session 2 – Feb. 12 – May 28 (15 weeks) Time: 2:50 – 4:00 - Room 111 TENNIS TGA of North Seattle runs after school enrichment programs to teach golf to elementary school students. Each class includes a rules and etiquette lesson, a character development theme, and an academic lesson in addition to sport-specific skills. Our programs each have five levels, so we are able to deliver appropriate instruction based on each child’s skill level. Instructor: Brad Kirkpatrick - bkirkpatrick@playtga.com Tuition: $105 per session - tuition includes hat and prizes. TGA will provide equipment. Grades: K-5 Minimum/Maximum Number: 6 & 20 (Grades K-2), 6 & 16 (Grades 3rd -5th) Dates: Session 3 - Feb. 26 - April 9 (7 weeks) - students will be in groups differentiated by age Session 4 - April 23 - June 4 (7 weeks) - students will be in groups differentiated by age Time: 2:50 – 4:00 - Lawton Commons RHYTHMIC GYMNASTICS Students will get experience with rhythmic gymnastics apparatus (ball, ribbon and hoop) and learn several routines combining dance and rhythmic gymnastics. The students will work on flexibility, endurance and hand-eye coordination while performing fun routines. Instructor: Laura Van Horne - lvhlee@yahoo.com Tuition: $175 per session - includes snack, t- shirt, rhythmic gymnastics ribbon, cd of music and end of the year performance. Grades: K- 5 Minimum/Maximum Number: 8 minimum and 20 maximum Dates: Session 2 – Feb. 19 – May 28 (14 weeks) * Dress rehearsal, Tuesday, June 2 – 2:50 – 5:00 * Date for end of the year performance: Saturday, June 6 Time: 2:50 - 4:00 - Lawton Gym FRIDAY PIANO KEYBOARDING Our class offers kids the opportunity to learn to play their favorite songs and music on electric keyboards. Radio hits, movie and television themes are made so easy, that our participants will be playing them after the very first class! The class is a combination of keyboard piano lessons and a music learning workshop, which uses a clever visual method to teach the basics of music reading and piano playing. Instructor: Warren Mendes - mendes2000@hotmail.com Tuition: $182 per session - tuition includes method book and learning tools Grades: K – 5th Minimum/Maximum Number: 8 minimum and 24 maximum Dates: Session 2 – Feb. 6 – May 8 (13 weeks) Time: 2:50 – 4:00 - Lawton Library HIP HOP DANCE Make your move with One on One Hip-Hop at Lawton Elementary as we explore the world of hip-hop dance. We will learn various individual moves each week as we build strength, flexibility and coordination through creative dance. We will learn how to function in a cohesive group and work together towards our final goal of performing for family and friends at the final session! Instructor: One on One Athletics - stuart@1on1basketball.com Tuition: $100 per session Grades: 2nd – 5th Minimum/Maximum Number: 8 minimum and 16 maximum Dates: Session 2 – Jan. 16 – March 13 (8 weeks) Session 3 – March 20 – May 15 (8 weeks) Time: 2:50 – 4:00 - Lawton Gym CREATIVE CODING FOR KIDS Give your child a gift that will last: Get them started on computer coding! Let's face it, kids love computer games. But with today's tools, they can be more than consumers. They can be creators! We teach kids the joy of coding, by helping them make their own customized computer games and animations! At our highly-regarded Creative Coding summer camps, day camps, and after-school programs, over 300 girls and boys all around Seattle have learned to code. Our "games and animations first" curriculum is fun, yet substantive and comprehensive. Your kids will have so much fun; they'll hardly realize how much they're learning. Instructors: Nick Dudley, Natasha Harrington, Alec McGovern - eric@creativecoding4kids.com Tuition: $195 per session Grades: 2-5 (2nd grade must have prior coding experience) Minimum/Maximum Number: 8 minimum and 12 maximum Dates: Session 3 - March 13 - May 8 (8 weeks) Time: 2:50 – 5:00 - Computer Lab Lawton PTA Before & After School Enrichment Program Registration Form STUDENT INFORMATION: (One Form per Student) Student Name Home Phone # ______________________________________Grade/Homeroom: ________________________________Home Address _____________________________________________________________ Parent 1 Name _______________Work Phone # Email Address: _______________ Parent 2 Name _______________Work Phone # Email Address: _______________ My child will be picked up _________ My child can sign out on his/her own __________________________Cell # _________________________ __________________________Cell # _________________________ My child will go to Boys & Girls Club *Please inform instructor if there is a change to the pick-up plan. IN CASE OF EMERGENCY: Emergency Contact #1/Relationship: Phone: ____________ Emergency Contact #2/Relationship: Phone: ____________ Allergies/Drug Reactions /Other medical Conditions: If yes, medication needed?*_ * Please note: Arrangements must be made directly with the instructor to provide access to an epi -pen or other emergency medications in case of emergencies. We cannot guarantee access to the school office where student medications are stored during after school programs. Parent Signature _________________________________________________ Date _________________________________________ MUST BE FILLED OUT 100% BEFORE STUDENT CAN START A CLASS PLEASE RETURN TO THE MAIN SCHOOL OFFICE BOX PROGRAM ART ADVENTURES (K-5) SESSION DATES DAY/TIME Session 2 - April 1 - May 27 INSTRUCTOR TUITION WEDNESDAY – 2:50 – 4:00 LAURA VAN HORNE $125 SESSION 8 WEEKS ONLY WED. & FRI. 7:30 - 8:30 AM ELAINE COOPER $200 SESSION TUES (WED) 7:30 - 8:30 AM ELAINE COOPER $170 SESSION TUESDAY – 2:50 – 4:30 CHERYL PARKS, SUE TURNER CIRCUS ARTS/TUMBLING K-5 Session 2 – Jan. 21 - June 3 (Wednesdays) Jan. 23 - June 5 (Fridays) Session 2 – Jan. 20 - April 8 (Tuesdays) April 22 - June 3 (Wednesdays) Session 2 - Feb. 10 - June 2 CLAY ART - K-5 Session 3 - March 12 – May 7 THURSDAY – 2:50 – 4:00 JANE MEAGHER CREATIVE CODING FOR KIDS (2-5) (2ND HAS TO HAVE CODING EXP.) CREATIVE CODING FOR KIDS (2-5) (2ND HAS TO HAVE CODING EXP.) Session 3 - March 11 - May 13 WEDNESDAY – 2:50 – 5:00 NICK DUDLEY, NATASHA HARRINGTON, ALEC MCGOVERN Session 2 - Jan. 9 - March 6 Session 3 - March 13 - May 8 FRIDAY – 2:50 – 5:00 NICK DUDLEY, NATASHA HARRINGTON, ALEC MCGOVERN $210 SESSION $80 SESSION 8 WEEKS ONLY $195 SESSION 8 WEEKS ONLY $195 SESSION 8 WEEKS ONLY Session 2 - Feb. 4 - May 6 WEDNESDAY – 2:50 – 4:00 ELIZABETH KRUSE $195 SESSION FRIDAY - 2:50 - 4:00 STU MITCHIE $100 SESSION 8 WEEKS ONLY TUESDAY – 2:50 – 4:00 $232 SESSION CHOIR (LAWTON) 3 - 5 CHOIR (DOLPHIN) K-2 DEBATE 4-5 HIP HOP DANCE (2-5) IPAD CLAY – MONSTERZ (K-5) Session 2 - Jan. 9 – March 13 Session 3 – March 20 – May 15 Session 2 - Feb. 10 - June 2 JR URBAN FOREST STEWARD (3-5) Session 2 - Feb. 9 - June 1 MONDAY – 2:50 – 4:00 KNITTING (1-5) Session 2 - Feb. 9 - June 1 MONDAY – 2:50 – 4:00 MUJALE CHESEBUKA KASSANDRA BRADBERRY BARBARA DOWNWARD DEANA METTEER, LISA BLAU PIANO KEYBOARDING (K-5) Session 2 - Feb. 6 – May 8 FRIDAY – 2:50 – 4:00 WARREN MENDES $182 SESSION RHYTHMIC GYMNASTICS (K-5) Session 2 - Feb. 19 – May 28 THURSDAY - 2:50 - 4:00 LAURA VAN HORNE $175 SESSION RUN LIKE THE WIND (K-5) Session 2 - Feb. 11 - May 27 WEDNESDAY – 2:50 - 4:00 KAMILA KILAYKO $140 SESSION SONGSTERZ SONGWRITING (K-5) Session 2 - Feb. 10 - June 2 TUESDAY – 2:50 – 4:00 JENNIFER SAVAGECRANE $195 SESSION TENNIS (K-5) Session 2 - Jan. 8 - Feb. 19, Session 3 - Feb. 26 - April 9 THURSDAY - 2:50 - 4:00 Session 4 - April 23 - June 4 BRAD KIRKPATRICK $105 SESSION 7 WEEKS ONLY UNICYCLE: ALL LEVELS (K -5) Session 2 - Feb. 9 - June 1 MONDAY – 2:50 – 4:00 CHERYL PARKS WATERCOLOR (K-5) Session 2 - Feb. 11 - March 18 WEDNESDAY – 2:50 – 4:00 CAROL MCKINNEY WORD MAGIC (K-5) Session 2 - Feb. 12 – May 28 THURSDAY – 2:50 – 4:00 JENNIFER SAVAGECRANE $195 SESSION ZUMBA KIDS (K-5) Session 2 - Feb. 11 - May 27 WEDNESDAY – 2:50 – 4:00 AMIE SCHUMER $190 SESSION $25 SESSION $165 SESSION $190 SESSION $65 SESSION 6 WEEKS ONLY Grand Total Enclosed Please note: A limited amount of tuition assistance is funded by the PTA. One program per child per session is eligible for tuition assistance as funds allow. Funding is limited and tuition assistance is not guaranteed. Enclosed is my check made out to the Lawton PTA for tuition in full $ _________ I am able to pay part of the tuition. I am requesting assistance for the remaining $ _____ I would like to set up a payment plan. I would like to donate an additional $ ______towards scholarship. I am requesting tuition assistance in full for my child. TOTAL