Excel Club Membership Fee Waiver Request

Exchange Club of Fontana – Excel Club Program The Exchange Club of Fontana believes that every student should have the opportunity to participate in Excel Club, regardless of their financial situation. If the annual membership fee presents a financial hardship, please complete this form. All requests will be kept confidential and reviewed by the club advisor.

Student Information

Name(Required)
Student Email(Required)

Parent/Guardian Information

Parent/Guardian Name(Required)
Parent/Guardian Email(Required)

Request Information

Excel Club Membership Payment The annual Excel Club membership fee is $20. You may choose one of the following payment options: Pay the full $20 when you submit your registration form. Split your payment into two installments: $10 due between registration and December 4, 2026 $10 due by March 5, 2027
Request Type(Required)
Please select the option that best describes your request.
Please briefly describe your situation. You do not need to provide sensitive financial information.

Student Acknowledgement

I certify that the information provided is true to the best of my knowledge. I understand that this request will be reviewed confidentially and that approval is not guaranteed.
Consent(Required)

Electronic Signature

By typing my full name below, I acknowledge that the information provided in this request is true and accurate to the best of my knowledge. I understand that my typed name serves as my electronic signature and has the same effect as a handwritten signature for the purpose of this request.
MM slash DD slash YYYY

Advisor Use Only

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