* Required

Parent Information

First Namerequired

Last Namerequired

Phonerequired

Emailrequired

Active Military or First Responder?*

Active Military First Responder

Student Information

First Namerequired

Last Namerequired

2025-26 Grade Levelrequired

Do you have more than one student?*

Yes No

First Name

Last Name

2025-26 Grade Level

First Name

Last Name

2025-26 Grade Level

First Name

Last Name

2025-26 Grade Level

Applicants must be active military or active first responder (law enforcement, firemen, and paramedics).
Applicants must be able to provide any and all requested documentation.
Applicants must provide a copy of military ID or orders. First responders must provide a copy of current check stub.

Acknowledgement*

I have read and understand the “Eligibility Criteria” section of this application.

Acknowledgement*

I understand that this 25% discount cannot be combined with any other need-based tuition assistance.

Certification*

I certify that all of the information provided is accurate and true.

Please send a confirmation email to the address below*: