UCHM After-school Financial Assistance Program Application Please enable JavaScript in your browser to complete this form.Parent/Guardian NameChild/Children NameHow many days a week will your child attend the program?1-2 Days2-4 Days5 DaysParent/Guardian Place of EmploymentAnnual Household IncomeHousehold SizePlease briefly explain why you are applying for financial assistance.What amount are you able to pay per week?$20$15$10$5$0WebsiteSubmit