Fillable Printable Family Allowance Form Sample
Fillable Printable Family Allowance Form Sample
Family Allowance Form Sample
7020F
Revised: 4/2013
Expenditure Choices:
First Tier
$0.00
Communication: Internet Services up to $300 : Complete
Form
$
On-Line Curriculum: Odysseyware ($250 per class or apply
the total allowance per child for complete offerings
$
Traditional Curriculum: Complete Form
$
Second Tier
$0.00
Individual Lessons or Tutoring: Music/Dance/Language
(aprox. $15/30 min. lesson or $20 per hr. tutoring)
$
Classes or Teams: Swim/Dance/Gymnastics (per request)
$
Technology Equipment: IPod/IPad/Kindle/Nook
$
Usage Fees: Computer ($50)/ Technology ($25)/
Replacements/ Repairs
$
Third Tier
$0.00
Swim Passes: in Hayward at $30 for 6 punches
$
Memberships: Science Museum/YMCA/etc.
$
Instrument Rental
$
OTHER: Upon Request
$
Allowance Total
$0.00
Tier Totals
$0.00
Remainder
$0.00
FAMILY ALLOWANCE FORM
2013-2014
Family Name: _____________________________________
ALLOWANCE CALCULATOR
ALLOWANCE CALCULATOR
ALLOWANCE CALCULATOR
ALLOWANCE CALCULATOR
Students
Students
Allowance
Totals
Grades K-4:
$800
$
Grades 5-8:
$900
$
Grades 9-12:
$1,000
$
ALLOWANCE TOTAL
ALLOWANCE TOTAL
ALLOWANCE TOTAL
$0.00