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Participation Agreement

Please read the following conditions for participation and CHECK EACH BOX to indicate your agreement.

If you do not agree to ALL of the following conditions, do not submit the application.

DISCLAIMER:  Registration does not guarantee your child's participation.  Sevier District's ability to offer this program is contingent upon receipt of grant funding.  Grant funding notification is not expected until late June/early July of 2019.  Applicants will be notified ASAP once Sevier District learns if funding has been awarded or denied.

Preferences
Child's Information
Primary Contact Information (Mother or legal guardian)
Secondary Contact Information (Father)
Risk Factor Assessment
  • Child was born to mother who was 18 years old or younger
  • Amember of child's household is incarcerated
  • Child lives in a neighborhood with high violence/crime
  • One of both parents has a low reading ability
  • Family has moved at least once in the last year
  • Child has ever been in foster care
  • Lives in a household with multiple families
  • Child exposed to physical abuse or domestic violence in the home
  • Child exposed to stressful life events (death, chronic illness or mental health issues of a parent or sibling)
  • Language spoken in the home most oftern is NOT English
  • A parent of the child did not graduate from high school
Income Information

If you are not sure of your elegibility click below to see the current income guidelines for free and reduced lunch.

Income Guidelines

Affirmation

I certify (promise) that all information on this application is true and accurate to the best of my knowledge.  School officials have my permission to verify the information on this application.  I understand that if I give false information or if I do not meet all of the terms of this agreement, my child(ren) will lose these tuition benefits. 

Deadline for application submission is August 1, 2019

DISCLAIMER:  Registration does not guarantee your child's participation.  Sevier District's ability to offer this program is contingent upon receipt of grant funding.  Grant funding notification is not expected until late June/early July of 2019.  Applicants will be notified ASAP once Sevier District learns if funding has been awarded or denied.