2021 SDC Financial Assistance

2021 Summer Day Camp Financial Assistance

A registration form must be completed and space secured in the program to be considered for financial assistance.

1. Each application MUST be accompanied by a 1040 tax form and two months pay stubs from the most previous tax year for ALL adults in the household. APPLICATIONS WILL NOT BE CONSIDERED WITHOUT THIS FORM BEING SENT TO THE GIRLS PLACE OFFICE BY April 30, 2021. You may bring the appropriate forms to the Girls Place office personally, a scanned copy may be emailed to lynn@girlsplace.net or a copy may be faxed to (352) 373-5550.
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 successfully securing a spot in the program.
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. Please note a child receiving assistance from ELC, (Early Learning Coalition), will not be eligible for additional assistance from Girls Place.
2. The administrative staff and the economic status of Girls Place shall determine the amount of members assisted and the level of assistance.
3. Financial assistance is good for one program only. If you are granted any assistance, it WILL NOT roll over to the next program your child participates in. However, you may apply for financial assistance for each program.
Personal
Parent Name*
First and Last Name
First Child's Name*
First and Last Name
Date of Birth*
Date Format: MM slash DD slash YYYY

mm/dd/yyyy
Current Grade*
Grade in AUGUST 2021*
School in AUGUST 2021*
Second Child's Name (if applicable)
First and Last Name
Date of Birth
Date Format: MM slash DD slash YYYY

mm/dd/yyyy
Current Grade*
Grade in AUGUST 2021
School in AUGUST 2021
Third Child's Name (if applicable)
Date of Birth
Date Format: MM slash DD slash YYYY

mm/dd/yyyy
Current Grade*
Grade in AUGUST 2021
School in AUGUST 2021
Residence
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone
Email address checked regularly*
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 2020 1040 Form and two months of pay stubs.*
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:*

2021 SDC Financial Assistance

2021 SDC Financial Assistance

2021 Summer Day Camp Financial Assistance

Financial Assistance Details

Personal

Residence

Finances

Girls Place