College For Kids Intake Form

College For Kids Intake Form

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College For Kids

INTAKE FORM

How to Apply

  1. Make sure your household size and income listed on your tax return meet our guidelines. See the Income Eligibility Chart below.
  2. Complete all sections of this Intake Form.
  3. Provide your financial eligibility documents and required student documents listed below.
  4. Submit the completed Intake Form and required documents.

Required Documents

Please provide one of the following documents for financial eligibility:

  • 2025 Tax Return
  • Medicaid Letter
  • SNAP Letter
  • TANF Letter

Also required:

  • Copy of Student's Social Security Card
  • Copy of Student's Birth Certificate

Income Eligibility

Household / Family Size Annual Income
1$45,000
2$51,400
3$57,850
4$64,250
5$71,558
6$82,066
7$92,574
8$103,082

For each additional family member, add $10,508.

Reminder: Total income before taxes, Social Security, health benefits, union dues, or other deductions must be reported. Household size is determined by the number listed on your tax return.

Confidentiality Statement

The College for Kids program is committed to protecting the privacy of our applicants. Any information and documents shared by students or parents/guardians during the application process will be kept strictly confidential.

This information will:

  • Be used solely for the purpose of evaluating program eligibility and providing appropriate services.
  • Not be shared with any outside agencies without your explicit written consent.
  • Be protected according to our privacy protocols and applicable guidelines.
  • Be accessible only to authorized College For Kids Future Makers personnel.

Your privacy is our priority. All submitted materials are securely maintained and handled with the utmost care and discretion by our staff.

Contact Us

Zana Sledge, Student Recruitment Manager
[email protected]
Call/Text: (561) 850-6251

College for Kids Intake Form

College For Kids

Section A : Student Information

Name
Enter the student’s 9-digit SSN. It is masked as you type, sent to Salesforce as numbers only, then removed from this website.
Address

Parent/Guardian Information

Parent/Guardian 1 Name
Parent/Guardian 2 Name

Income & Eligibility

Social Services Received
Eligibility Factors
Max. file size: 50 MB.
Max. file size: 50 MB.

Consent for Release of Education Records

I, the undersigned parent or legal guardian, authorize the College for Kids program and its designees to access my child’s education records for the purpose of providing academic and mentoring support. This includes, but is not limited to, grades, test scores, schedules, attendance, disciplinary history, extracurricular activities, and any related assessments. I release the College for Kids program and its partners from any liability resulting from the use of this data and understand that this consent remains in effect while my child is enrolled in the program unless revoked in writing.(Required)
Clear Signature
Clear Signature

1800 S. Australian Ave, STE 301
West Palm Beach. FL 33409

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