PHSA Financial Aid Form

Please email or mail a copy of the parents 2017(and 2018 if available) tax return(s) once this application is submitted.

    Applicant Information


    Supplemental Security Income (SSI)Temporary Assistance for Needy Families (TANF)Supplemental Nutrition Assistance Program (SNAP)Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)Free or Reduced Price School LunchNone
    MotherFatherFamilyRelativeFamily Friend