Application Form

Be Cool for School 2021 – Feeling good both inside and out!

With MPS students returning to school after a year of uncertainty and variations of distance learning, MYFS would like to help!  This program is intended to help Madison families manage any level of back-to-school nerves and may also provide some $$ help with some of those back-to-school costs!

Parents – Are you noticing signs of worry or anxiety in your children related to school?  

Get Information and Resources – Check out our Webpage and the “Be Cool for School” tab for back-to-school tips to address the issues related to these unique times.  Find resources too!

Concerned about finances and want to get that special back-to-school item for you student? 

Apply for our one-time assistance program for a $75 gift certificate to an Outlet Mall and gift certificate to a local salon to go towards a haircut.

Madison Youth and Family Services has been granted special funding through the COVID-19 Recovery Fund from the Town of Madison to help prepare students to return to full in-person school in the Madison Public School District.  This program has been created to help mitigate the impact that COVID-19 has had on families, and is intended to encourage positive family interactions related to back-to-school rituals such as shopping and haircuts. This program offers gift cards that are intended to be utilized for back to school items, clothes, and a local haircut.  

To be eligible, applicants must be a parent or guardian to a child or children enrolled in Madison Public Schools in grades K-12 that have been negatively impacted financially by the COVID pandemic in some way, and/or are concerned with anxiety related to their children returning to school.  Applicants determined to be eligible would receive one gift card to an outlet mall and one gift certificate for a haircut, per child per household, as long as we have funding.  

Applications must be completed in full.  Applications may be submitted online through the madisonyouthservices.org webpage “Be Cool for School” tab, or parents may download and submit via scan/email.  Scanned applications may be submitted via email to madisonwillrise@madisonct.org with “Be Cool for School Program” in the subject line of the email.  MYFS Staff will be available to answer questions and provide guidance over email and/or via phone.  All applications will be processed in the order that they are received.  

Applications may also be faxed to (203) 245-5648 to the attention of “Be Cool for School Program.”   Applicants are discouraged from mailing given the potential time lag, however if an application is received via mail it will be processed and time-stamped as of the date of receipt.   Arrangements can also be made over the phone to drop off the applications if necessary.  If granted this assistance, applicants will be notified via email or phone with instructions as to how to pick up the gift certificates.  

If you have any questions, please call our office at 203-245-5645.  

Be Cool For School

  1. Madison Youth & Family Services
  2. Be Cool For School

    To apply, a parent or guardian for a student or students must complete and submit this application.  Please note, this is a different program from our annual back to school supply program which will continue to run separately. If you are interested in that program please contact our office for more information. Thank you.

  3. Names and grades of the child(ren) you are applying for:
  4. Household Eligibility (Please check only one box):
  5. Further Assistance Needed:
  6. By signing this form, I am attesting to the information being provided by me as the applicant as true and accurate.  I am aware that applications will be processed in the order that they are received, and assistance will be granted to those who are determined to be eligible as long as there are funds available.  I understand that by submitting this application it does not guarantee that if deemed eligible I will receive the assistance.  I attest that my child is enrolled in the Madison Public Schools system for this academic year.   


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