2025-2026 PPZ Book/Supplies Reimbursement Form

Pontiac Promise Book/Supplies Reimbursement Form

PLEASE READ CAREFULLY! To be eligible for book reimbursement, you would need to have received a determination letter for the corresponding semester you are applying for book reimbursements. If you have not received this letter, you will need to complete your application for that semester. If you have questions, please email us at scholarship@pontiacpromisezone.org.

Student Information

First Name

Last Name

Birthdate

Email (DO NOT use your school email)

Cell Phone Number

What address would you like the check sent to? PLEASE INCLUDE THE CITY AND ZIP CODE! Your check will be delayed if this is not included.

What semester are you applying for book reimbursement?

Winter/Spring 2025 (January-May)Spring/Summer 2025 (May-August)Fall 2025 (August-December)Winter/Spring 2026 (January-May)Spring/Summer 2026 (May-August)

Class/Program Schedule

Please upload your class schedule or program schedule.

Receipts/Proofs of Purchase

Please upload your receipts/proofs of purchase. Make sure they are clear and legible.

If you have any additional receipts/proof of purchase, please upload them here. Make sure they are clear and legible.

Class Syllabi

Please upload your class syllabi. Your books and materials must correspond with your course requirements.

If you have any additional class syllabi, please upload here. Your books and materials must correspond with your course requirements.

Contact Information