After School Program Sponsorship Application
Tell us more about you so we can get back to you on ways we can help.
First name
Last name
Email
Phone Number
Address
How did you hear about us?
Friends
Facebook
Instagram
Word of Mouth
Other
What program are you seeking sponsorship for?
After School Program
Summer Camp
Marital Status
Widowed
Married
Single
What is your CURRENT MONTHLY household income?
Number of dependent children living with you who depend on you for support?
Do your children participant in the free or reduced lunch program at their school?
Yes
No
Email
If you do not qualify for government assistant programs, such as Chip, TANAF, Food Stamps or Medicad, please explain why you are needing financial support for after school programs for your child(ren).
List all names and grade levels for children needing sponsorship.
What school does your child attend?
Do any of your children have behavior challenges or disabilities? If so, please explain. If no, please type NA.
Upload proof that your child is enrolled in a free lunch program or proof that you are actively participating in a government assistance program.
Select a PDF File
Upload your most recent W2
Select a PDF File
If you are awarded this sponsorship, how would this impact your family and child?
For aggregate reporting purposes, what is your ethnicity?
African American
White
Hispanic
Asian
American Indian or Alaska Native.
Native Hawaiian/Pacific Islander
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