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Reduced or Waived Fee Request


If you represent a school or organization that might benefit from our program, but cannot afford to participate, please fill out and submit the form below.

* indicates required field

Date of Request December 20, 2014
* First Name
* Last Name
* Email
* Email Again
Organization
NPO number (if applicable)
Director of your organization
Address
City
State
Zip
Country
Phone
Mobile Phone
Fax
Other Phone
Please tell us what fee assistance you are requesting and why
How did you hear
about us?
Please tell us what times of year, month, week and day are good for your group to attend TSNY Los Angeles
Please tell us about your group. Be sure to include number of participants, ages, program desires and special needs.
Please give us one reference who is not in your organization
Reference Phone
Insurance
* Emergency Contact
* Please enter the numbers in the following image: