ESA: Forms

Please submit all completed forms to Help Desk.

Applicant Forms

(to be used when applying for ESA)

• For proof of residency you can utilize the Affidavit of Shared Residence Form.
• If applying under Legal Guardian is Blind: Blindness Confirmation Form
• If applying under Legally Deaf/Hard of Hearing: Confirmation of Deaf or Hard of Hearing

Current Recipient Forms

(for parents currently using ESA)

• The Request to Close your ESA Account should be sent to: [email protected]
  • Close Account Request Form

Other Documents

• Funding Chart - Approximate ESA Award Amounts