Financial Assistance Application

Please complete the form below. Of course, all information you provide is strictly confidential. We will be in touch shortly.

Parent Name *
Parent Name
Student Name *
Student Name
Address *
Address
Phone Number *
Phone Number
Is this your first request for financial assistance from CUE52? *
Have your student(s) attended CUE52 programs in the past? *
$
Verification
I certify that information contained in this application is true and complete. I understand that false information may be grounds for rejection of financial assistance. I authorize the verification of any or all information listed above.
Date *
Date