return to the church office. Student’s Name __________________________________________________________ Parent’s Name(s)__________________________________________________________ Address ________________________________________________________________ City ________________________ State _____________ Zip ______________________ Home Phone ___________________________________ Grade ____________________ I am applying for assistance for (event) ________________________________________ The total cost of this event is $________, and I am requesting help with ______ % of the cost (maximum is 50%). Please describe your student’s involvement with BRICK Ministries _________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Why do you believe that it is important for your son/daughter to attend this event? _____ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Please describe the situation that causes your need at this time in as much detail as possible. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Staff use only Approved Amount___________________________________________ Staff Name_________________________________________________ Please keep our response confidential. Our response is based on the individual need of each applicant.