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Financial assistance application

This is an application only and does not guarantee that financial asisstance or the program will be available when you register. Due to limited funding, if your child(ren) cannot attend the program/camp you register your child for, please notify us at least five (5) business days prior to the start of the camp/program so that funding is available for another child.

Personal information contained on this form is collected under the authority of the Municipal Act, 2001, S. O. 2001, c. 25 and will be used for the sole purpose of pre-approving your financial assistance application. Questions about this collection should be directed to the Director of Parks Services, 58 Dalhousie Street, Brantford Ontario, N3T 2J2. Phone: 519-759-4150.

Main contact's first and last name

Preferred email address

Street number

Street name

Unit/Apartment

City/Town

Postal code

Phone number (mobile preferred)

Please enter all of the names of the child(ren) that you are applying for below.

First child's first name

First child's last name

First child's birthdate

Second child's first name

Second child's last name

Second child's birthdate

Third child's first name

Third child's last name

Third child's birthdate

Fourth child's first name

Fourth child's last name

Fourth child's birthdate

Please indicate your relationship to the child/youth

Has anyone in the family received financial assistance for recreation programs/camps for this current session?

Yes

Please indicate the number of ADULTS in the family household

Please indicate the number of CHILDREN in the family household

What is the gross family HOUSEHOLD income?

We require verification of income from all family sources of income in order to process financial assistance applicants. You must be able to provide the following documents to apply. You can upload a photo or scan of the required documents below.

If you are currently on Ontario Works or Ontario Disability Support Program (ODSP):

Current pay stub and Drug card or Healthy Smiles card or;
Current pay stub and Child Tax Benefit (child(ren’s) names must be listed)

If you are not on Ontario Works or Ontario Disability Support Program (ODSP) but still qualify for financial assistance:

Income Tax Form or Notice of assessment and a current pay stub or;
Current pay stub and Child Tax Benefit or;
Employment Insurance Stub and Child Tax Benefit

Please attach a photo/scan of your documents.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Signature of main contact (Signing certifies that the information on this application is correct and can be substantiated.)

Clear

Please enter today's date.