FINANCIAL ASSISTANCE APPLICATION

ELIGIBILITY

  1. JOYS Gymnastics, Incorporated is welcoming to all persons regardless of age, sex, ethnic origin, religious affiliation or ability to pay.
  2. Only those with an income at or below 150% of the poverty levels (as determined by the Federal Government), or those who have had an extenuating circumstance which has temporarily reduced their income are eligible to apply.
  3. Assistance is available for class sessions and team fees effective January 1, 2016.

 

APPLICATION PROCESS

  1. All applications need to be completed in full and are completely confidential. Incomplete applications will not be accepted.
  2. Applicants must submit income documentation, letter why assistance is needed and any other supporting materials with their application.
  3. Applications should be turned into the Office Manager and are due the 28th of each month.
  4. Assistance is limited to between 25% – 50% of fee; meaning all approved applicants will be asked to pay the remainder of their fee.
  5. All financial assistance applications will be reviewed by the Board of Directors at their monthly meeting (usually the first Thursday of the each month).
  6. Financial assistance is granted at the sole discretion of the Board of Directors based on the amount of money needed and allotted to the assistance fund.
  7. The Office Manager will notify each applicant of the resolution of their application.
  8. To renew your financial assistance, you will need to submit a new application prior to the expiration of the previous application in order to avoid a lapse in coverage.
  9. To reapply for assistance you will be asked to submit a letter stating how the assistance has helped your family.

 

TERMS OF ASSISTANCE

  1. Assistance is given for the following time period:
  2. Class Session             (3) months                      b.  Team Fees                 (6) months
  3. All applicants that receive assistance will be required to volunteer (5) hours (during 3 month period) for class assistance; and (10) hours (during 6 month period) for team assistance. Failure to complete your volunteer hours will result in immediate loss of financial assistance and a one year ban from further assistance.

The Office Manager will maintain a record of all volunteer hours assigned and completed and will forward this information to the Board of Directors on a monthly basis for their review.

 

 

DATE RECEIVED _____________

Financial Assistance Application

Name:______________________________________________      Family Size: ___________

Phone Number: _______________________     E-Mail:____________________________

Address: ____________________________________________________________________ City: ____________________________

State:_______                Zip:___________

Name(s) of ALL members of your household:                                                  Check if  Program Participant

  1. __________________________________________ Age__________           _____
  2. __________________________________________ Age__________           _____
  3. __________________________________________ Age__________           _____
  4. __________________________________________ Age__________           _____
  5. __________________________________________ Age__________           _____
  6. __________________________________________ Age__________           _____
  7. __________________________________________ Age__________           _____

Are you applying for             CLASS SESSION        and/or        TEAM FEES

Have you ever applied for assistance before?             YES            or      NO   

If yes, when and why: __________________________________________________________

What is your annual household income?:_ ________________________________________

Please submit a copy of one the items below showing your current household income:

  1. Most recent tax return
  2. Most recent W-2s and/or 1099s
  3. (3) of your most current paystubs
  4. Social Security Award letter
  5. Unemployment verification
  6. Child Support Print Out (including payment history)

Please attach a letter stating why you are applying for assistance.

*I certify that the above information is true and complete. I also agree, if approved for assistance to follow all guidelines as are stated in the application.

 

________________________________________________________________________________________________________

Signature                                                                                                     Date

2018-2019 FEDERAL POVERTY GUIDELINES