Student Application

For Martial Arts Financial Assistance

Note: By submitting this form, you acknowledge that we will be requesting additional information regarding the financial assistance required (full or partial) and the circumstances necessitating the financial assistance. You may be asked to submit additional documentation such as a letter confirming free or reduced lunch or other verification. All information submitted will be kept private within the KIAP Foundation.

Student Information

First Name

Last Name

Student's Birth Date

YYYY

Student's Grade

Student's Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Adult Completing Application

First Name

Last Name

Email Address

Phone Number

(###)

###

####

Relationship to Student

Preferred Martial Arts School