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Scholarship Application
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Email
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Your email
Your Name
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Your answer
Phone number
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Your answer
Email address
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Your answer
List ALL adults living in the household, relationship to child and annual gross income. example: Linda, mother, $25,000
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Your answer
List ALL minors living in the household and their age
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Your answer
Please list for which program you are requesting a scholarship
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Your answer
How much of the program fee could you pay?
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Your answer
Please explain why you need a scholarship:
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Your answer
Public Assistance: Please check all assistance that the family is currently receiving:
Medicaid
Disability
TANF
Child Support
Food Stamps
Other:
Please scan proof of income (last two paystubs or tax return) to
enroll@bgcnorthcounty.org
.
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I agree
Required
By signing below, I attest that all information provided on this document is truthful and accurate on the date of completion. I further understand that Boys & Girls Clubs of North County will make every effort to assist families, but due to budget constraints ALL SCHOLARSHIP APPLICATIONS MAY NOT BE APPROVED. All families will need to re-apply for scholarships at the beginning of each term in order to continue receiving the scholarship. (type name below as signature)
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A copy of your responses will be emailed to the address you provided.
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