Application for Athletic Fee Waiver

1
Parent/Guardian Information* This field is required.
Name
2
Contact Information* This field is required.
Address
City
Zip Code
Please enter your phone number
Please enter your email
3
Student Information* This field is required.Student
Name of Student
Please Select
Please Select
Sycamore Middle School
Sycamore High School
School
Please Select
Please Select
Sixth Grade
Seventh Grade
Eighth Grade
Ninth Grade
Tenth Grade
Eleventh Grade
Twelfth Grade
Grade
Please Select
Please Select
Baseball
Basketball
Bowling
Cheerleading
Cross Country
Dance
Football
Golf
Gymnastics
Soccer
Softball
Swimming
Tennis
Track & Field
Wrestling
Volleyball
Sport
4
Please select the reason for your request.* This field is required.
The student(s) entered are currently receiving aid under Article IV of the Illinois Public Aid Code - Aid to Families with Dependent Children, AFDC. (Snap, TANF, of Medicaid)
The student(s) entered are currently eligible for free meals pursuant to 105 ILCS 125/1 et sq (Income Based Application)
There are other reasons why I am unable to afford the school fee(s) assessed to the student(s) entered.
5
Please explain why you are unable to afford the school fee(s) assessed to the student(s) entered. * This field is required.
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6
By clicking submit, you are aware that supplying false information to obtain a fee waiver is a Class 4 felony (ILCS5/17-6). I attest to the statements made herein are true and correct.
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