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160 West 78 Street, New York, NY 10024 * 212.873.0490 * www.87afterschool.org
Reduced-Rate Tuition Application Fall 2025
Child Information (attending 87 Afterschool Only)
(1) Last Name: ________________________ First Name: _____________________Grade______
(2) Last Name: ________________________ First Name: _____________________Grade______
(3) Last Name: ________________________ First Name: _____________________Grade______
Parent Information
Parent/Guardian (1): ______________________________________________________________
Home Address: __________________________________________________________________
City, State: _________________________ Zip: __________ Home Phone: __________________
Cell Phone: ___________________________ Email: ____________________________________
Occupation:____________________________Work Phone:_______________________________
Child lives with this parent _______________
Parent/Guardian (2): ______________________________________________________________
Home Address: __________________________________________________________________
City, State: _________________________ Zip: __________ Home Phone: __________________
Cell Phone: ___________________________ Email: ____________________________________
Occupation:____________________________Work Phone:_______________________________
Child lives with this parent _______________