2020 Athletics Financial Assistance

1. Each application MUST be accompanied by a 1040 form from the most recent tax year. APPLICATIONS WILL NOT BE CONSIDERED WITHOUT THIS DOCUMENT BEING SENT TO THE GIRLS PLACE OFFICE BY the established deadline of each sport. You may bring the appropriate forms to the Girls Place office personally, a copy may be faxed to (352) 373-5550 or emailed to charlie@girlsplace.net

2. Need will be assessed by administrative staff based upon the responses to the questionnaire below.

3. An application will not be considered without EVERY question being answered and the registration form submitted prior.

Financial Assistance Details

1. Receipt of assistance does not entitle a member to full assistance. In most cases, when assistance is granted, parents will be responsible for some of the fees for the program.*

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2. The administrative staff and the economic status of Girls Place shall determine the amount of members assisted and the level of assistance.*

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3. Financial assistance is good for one season only. If you are granted any assistance, it WILL NOT roll over to the next program your child participates in.*

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Personal

Which program are you applying for assistance?*

Parent Name*

First and Last Name

First Child's Name*

First and Last Name

Date of Birth*

mm/dd/yyyy

Grade as of AUGUST 2019*

Second Child's Name (if applicable)

Date of Birth

mm/dd/yyyy

Grade as of AUGUST 2019

Third Child's Name (if applicable)

Date of Birth

mm/dd/yyyy

Grade as of AUGUST 2019

Residence

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Cell Phone

Email address CHECKED REGULARLY. Email will be our primary form of communication leading up to the athletic program.*

Number of adults (18 years old and up) living at above residence:*

Number of children (0-17 years old) living at above residence:*

Do any of the above residents have special needs?

Yes
No

If yes, please describe:

Finances

Amount of combined annual income for ALL adults at the above residence. This has to be verified with your most recent 1040 Form.*

Does your child qualify for the FREE or REDUCED lunch program at school?*

Free
Reduced
None
I do not know

Describe any federal, state, or local assistance the family is currently receiving (i.e. Food Stamps, Medicaid, Early Learning Coalition, etc.). Please note that a child currently receiving assistance from ELC will not be eligible for additional assistance from Girls Place.

In addition, please write a brief statement describing why you feel your family is in need of financial assistance for one of our programs. Be sure to include a description of any financial constraints above and beyond the eligibility requirements.*

By typing my full name below, I hereby agree to abide by the rules and regulations of Girls Place, Inc., as they relate to my application for financial aid:*

Date*