EmailMe Form - Grant Application for Recreation Programs 2023

Name or person requesting *

First Last

Phone *

### - ### - ####

Applicant's Birthdate *

MM / DD / YYYY

Email *

Address *

Street Address City State / Province / Region Postal / Zip Code

Participant 1's Name *

First Last

Participant 1's Birthdate *

MM / DD / YYYY

Participant 2's Name

First Last

Participant 2's Birthdate

MM / DD / YYYY

Participant 3's Name

First Last

Participant 3's Birthdate

MM / DD / YYYY

Participant 4's Name

First Last

Participant 4's Birthdate

MM / DD / YYYY

Amount You Can Afford To Pay *

$ Dollars . Cents

Total Income (According to Line 9 of 1040, 1040A, or 1040EZ filed this year) *

$ Dollars . Cents

Household Size *

Program Name/Activity Number and Participant Name and Age *

Please Check All That Apply *

If you have applied for Financial Aid from GP&R (Residents ONLY)

If you have previously received a program grant

I would like the opportuntiy to volunteer.

Not Applicable

Please describe your need for a grant. *

Please describe why you would like to sign up for the programs listed above. *

Please include any other information you feel would be helpful in reviewing your application.