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SEE US Application

Apply directly to schedule your consultation with a SEE US expert. Please complete the fields so we can confirm your eligibility and get you scheduled. If you require assistance to apply, please email us at SEEUSadvocacy@gmail.com

Name

First Name

Last Name

Phone

(###)

###

####

Alternate Phone

(###)

###

####

Have you previously used SEE US?

Who referred you to SEE US?

ABOUT YOUR LEARNER

Student's age

Student's date of birth

Student's grade

Name of student's school

School District/County

Is the child currently on any educational plans?

Do you have any upcoming meetings? If so, when?

Briefly describe your educational concerns.

FINANCIAL NEED

Financial Need: How many people are in your immediate family?

Financial Need: What is your annual income?

Are you receiving financial support/relief from any programs?

Housing assistance

Medicaid

Free and reduced meals

Utilitiy Assistance

Other

None

DOCUMENTS

How Can We Help?

Have a question? Need help with the SEE US application? Please share some information with us and a SEE US expert will get in touch with you.

Name

First Name

Last Name

Phone

(###)

###

####

Alternate Phone

(###)

###

####

Have you previously used SEE US?

Message

Who referred you to SEE US?