BPS Family Assistance Fund

Please note: This form needs to be filled out by a BPS counselor and/or social worker. If you are in need of assistance, please contact your child’s school.

BPS Family Assistance Funding Application

BPS Staff requesting funds(Required)

First Name Last Name

BPS Staff Phone Number(Required)

BPS Staff Email(Required)

Student's Name(Required)

First Last

Please note: If you have multiple children attending BPS, please list the oldest.

BPS School(s) attended by Student (and/or their siblings)(Required)

BECEP

Bismarck High School

Centennial Elementary

Century High School

Grimsrud Elementary

Highland Acres Elementary

Horizon Middle School

Legacy High School

Liberty Elementary

Lincoln Elementary

Miller Elementary

Moses Elementary

Murphy Elementary

Myhre Elementary

Northridge Elementary

Pioneer Elementary

Prairie Rose Elementary

Roosevelt Elementary

Simle Middle School

Solheim Elementary

South Central High School

Sunrise Elementary

Wachter Middle School

Will-Moore Elementary

Does the student's household currently receive benefits from any of the programs shown below? (Click all that apply.)(Required)

Food Distribution Program on Indian Reservations (FDPIR)

Supplemental Nutrition Assistance Program (SNAP)

Temporary Assistance Program for Needy Families (TANF)

No benefits are provided from the above programs at this time.

Does the student currently qualify for free and/or reduced lunch?(Required)

Yes

What amount of funding are you looking to receive?(Required)

Please give a description of how the funds will be utilized.(Required)

Have you utilized any existing community resources to fill this need? If so please list.(Required)

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Questions should be directed to:

Stacey Lang
Development Director
701-323-4093