In addition to submission of this form please provide the following information to the Program Coordinator at your school or Program Director at the Central Office for all adults living within your household: > your last W-2 form/s and tax statement showing line 37 > last paycheck stub/s > student loan statement > child support verification > or any other documentation that supports verification of your income listed as gross income on your tax document. > a copy of the DSS denial or waiting list letter showing your were denied or are currently on the waiting list.Not providing requested documentation and information will result in a delay of approval. Subsidy does not start until the day of approval. The date of application is automatically recorded when it is submitted. You will be notified by e-mail of approval or denial.
To be eligible for the first day of the program August 20, 2018, this application must be submitted on or before August 10, 2018. All applications received after 4:30 p.m. on this date will be considered the for the following month provided spaces are still available. Must apply for a minimum of 4 days. Since reduced rate scholarships are extremely limited, priority will be given to applicants applying for the most days of care and the youngest children needing care. Middle School Volunteers are not eligible for the Reduced Rate Scholarship.
Privacy Act StatementThe confidentiality of the information on this application is protected by the "Right to Privacy Act (1974)". This information will only be used to determine your eligibility for reduced rates for the after school program.