All financial assistance notification will be sent by email
First Name
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Last Name
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Email
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Phone
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Address
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City
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State/Province
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Zip/Postal Code
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Country
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Country
Current Status
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I am not currently receiving Financial Assistance
Receiving financial assistance this is for (Renewal or Request of another program)
Requesting Financial Assistance for:
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Summer Camp
Holiday Camp
Child's First Name
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Child's Last Name
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Household Income last year
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$
Upload Latest Tax Return or Income Affidavit
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Click to upload
PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF
Please share with us your need for financial assistance in 500 words or less.
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