Skip to content
Menu
Home
About
Resources
Apply for Assistance
Donate
Contact
Mailing List
Menu
Home
About
Resources
Apply for Assistance
Donate
Contact
Mailing List
Apply On-line
admin
2021-02-04T20:48:53-05:00
Applicant Information:
First Name
*
Last Name
*
Email
*
Phone Number
*
Address
*
(Applicant must be a resident of the Orange School District.)
Additional Household Members
*
Employment Income Used to Support Your Family / Household:
Income Earner's First Name
*
Income Earner's Last Name
*
Monthly Income to Report
*
Employer Name and Contact Information
*
If there is a second income earner in your household?
*
No
Yes
Second Income Earner's Name
*
Second Earner's Monthly Income to Report
*
Second Earner's Employer Name and Contact Information
*
Do You Have Additional Sources of Income Used To Support Your Family / Household?
(Social Security Benefits; Child Support; Workmen’s Compensation; Disability Income; Alimony, etc.)
*
No
Yes
Earner's Name
*
Monthly Income from Additional Source
*
Income Source
*
Total Monthly Income
*
Amount Requested
*
Reason for Request
*
Please attach any supporting documents:
Choose File
Please list Supporting Contact(s) with Phone Number (i.e. Case Worker):
Have you, or anyone in your household / family applied for help from OASC before?
*
No
Yes
Please give the reason, the amount received and the approximate date of the request(s):
*
Please initial and date here to certify that, to the best of your knowledge, the provided information is true and accurate.
*
Thank you for your message. It has been sent.
×
There was an error trying to send your message. Please try again later.
×
Submit Application
Page load link
Go to Top