Martin Luther Academy Church Tuition Assistance Form (Ctaf)
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112-month payment plans: complete by May 25
10-month payment plans: complete by July 25
Martin Luther Academy
2-payment plans: complete by July 15
1-payment plans: complete by July 15
Church Tuition Assistance Form
(CTAF)
Please complete the following information, obtain church representative signature, and return this
form in a sealed envelope addressed to Principal, Martin Luther Academy. Tuition accounts will be
credited with the church assistance amount after all signatures have been obtained.
Student Name:
_________________________________________________
Parent/Guardian:
_________________________________________________
Academic Year:
________________________
Grade: _____________
Church Information
Name:
_________________________________________________
Address:
_________________________________________________
City/St/Zip:
_________________________________________________
Phone:
_________________________
E-mail:
_________________________________________________
Church Tuition Assistance
Tuition amount
$_______________
Assistance amount
$_______________
or
Percentage ____________%
______________________________________________________
________________________
Parent/Guardian Signature
Date
______________________________________________________
________________________
Church Representative Signature/Title
Date
______________________________________________________
________________________
MLA Representative Signature/Title
Date
Original – MLA Office
Copy – Church
Copy – Parent/Guardian
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