Class Fee Assistance Form

Class Fee Assistance

Name(Required)

First Last

Email(Required)

An Activnet account is required. Set up one here:

Click here to register

Phone Number(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Do you currently receive financial assistance via any of these programs: SNAP, EBT, SSI, Medicaid,?

Yes

If NO, please briefly describe your financial challenges.(Required)

How will this class help you?(Required)

Class Preference

Click here for Class Listings We make incredible effort to get students into their preferred class but cannot guarantee priority placement due to the registration process. Using the current class offerings (link provided will open a new tab) please complete the sections below with the class name, day, & time.

First Choice

Day and time of Class

Second Choice

Day and time of Class