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Technology Support Application

Full Name of Child:
Date of Birth:
School Enrolled in:

Parent/Guardian Full Name(s):
Home Address:

Occupation:
Are you a Canadian Citizen:
Phone Number:
Relationship to Child:
Email Address:



Secondary Parent:
Phone Number:
Occupation:

The child above is enrolled in . Currently in Grade

Parental Explanation

Student Essay

Income Verification

Which documents are being attached:

Student Verification

Termination

This application may be terminated at any given time by either party. If the applicant is not reachable upon designated scheduled communication (call or meeting) the application may be withdrawn immediately.

APPROVED TERMS AND CONDITIONS

AGREED TO PRIVACY POLICY

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Your legal name

Your email address

Please Confirm full name and signature.

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Signed by Step Up 4 Kids Foundation
Signed On: February 6, 2023

Timestamp

Audit

April 18, 2021 12:00 am MST

Technology Support Application Uploaded by Catherine Turner - admin@stepup4kidz.ca IP 70.73.121.237