Form Center

2. Applicant Information

   Applicant must be a residing Hanover Park parent or guardian. Documentation verifying the address and relationship to each child must be submitted i.e.birth certificate, court documents.

4. Applicant Name*
5. Email*
7. Relationship to Child*
8. Documentation Verifying Relationship*

   Submit only one document per child.

9. Type of document*

   1. Birth Certificate
   2. Court Documentation
   3. Other
13. Address
15. Street*
16. Suite/Apartment Number
17. City*
18. Zip*
20. State*
21. Phone Number*
22. Documentation Verifying Address*
23. Type of Document*

    1. Government Issued ID
    2. Utility Bill
    3. Bank Statement
    4. Paycheck Stub
27. Proof of Need

    You may submit documentation of government aid as proof of need. If you are not enrolled in any government aid programs, you will need to submit proof of income

29. Proof of Government Aid*

    general assistance, disability assistance, food stamps, or other prequalified governmental aid.

30. Proof of Income*

    tax returns, a w-2 tax statement, or a current payroll stub check verifying all sources of current income.

34. Scholarship Recipient

    List each child and the program's name & cost.

36. 1. First Name*
37. 1. Last Name*
38. 1. Program Name*
39. 1. Cost*
41. 2. First Name
42. 2. Last Name
43. 2. Program Name
44. 2. Cost
46. 3. First Name
47. 3. Last Name
48. 3. Program Name
49. 3. Cost
51. 4. First Name
52. 4. Last Name
53. 4. Program Name
54. 4. Cost
56. 5. First Name
57. 5. Last Name
58. 5. Program Name
59. 5. Cost
63. Today's Date*
    Today's Date
64. Applicant's Name*

    DISCLAIMER: By typing your name here, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

Leave This Blank:


66. 1. Receive an email copy of this form.
67. Email address

    This field is not part of the form submission.

68. Submit

* indicates a required field