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Parent Membership Agreement


$125.00 Annually Per Parent, Per Child up to 12th Grade

(*No up-front, out-of-pocket membership fees for parents)


To create the customized “Parent’s Promise” Plan required for parents to access academic, educational, 

and extra-curricular, transportation, housing and healthcare 'Pay Incentives' for their child(ren) 

from birth through the 12th Grade; To Consult on the processing and obtaining of 'Pay incentives'. 

'Pay Incentives' can be  over a 12-month membership period.

Am I Eligible For Membership?*

(*all boxes must be checked)

Membership Type(s) *

Number of Children*

Phone Number*

Email Address*

SERVICE (*Check All):*

OPTIONAL FEES: Any applicable fees can be put on Paycare Card and be 'rolled into' Pay Incentive (*Check All):

**Signatures** (Check All): *

Disclosure Acknowledgement*

E-Signature Date*

E-Sign (Type Your Name)*

Thank you for contacting us. We will get back to you in 24 to 48 business hours! Don't forget to go back & complete links #2 and #3.

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