HTOP Fee Waiver Agreement and Online Form

As part of our Heroes Therapeutic Outreach Program, The Learning Center at Red Willow is proud to make all of its courses available to all veterans and active duty military personnel, their families and caregivers, as well as our community’s first responders.

While we are happy to have people sign up for our classes, please only sign up for a course you can honestly commit to. We would hate to turn people away, only to discover that there was a class opening that could no longer be filled.

Consequently, barring extenuating circumstances, we reserve the right to terminate waiver eligibility if two or more classes are missed without prior notice/negotiation.

Protecting access to your Voucher Code is your personal responsibility. The sharing of your voucher code for use by anyone else is grounds for immediate dismissal from the HTOP Fee Waiver program.

Your information will be held for a year, pending an annual status review. All information provided is confidential, and your privacy will be protected.
Email*
Phone*
File Upload
Accepted file types: jpg, gif, png, pdf.
Please upload a scan of your document here. If you prefer, you may bring your document to the Learning Center in person at 825 W. Kent.
Document Type (DO NOT record ID #)
I have read, understand, and agree to the HTOP Fee Waiver Program Policies:
Name*
First Last
Date*
Date Format: MM slash DD slash YYYY
Signature*
Additional Information

Before Footer