Application for
Children’s Program Grant
Funding for
youth grants provided by Blizzard Ball Softball and The Shirt Shop
CHILD’S
NAME______________________________________________AGE_______
CHILD’S NAME______________________________________________AGE_______
CHILD’S
NAME______________________________________________AGE_______
PARENT/GUARDIAN____________________________________________________
ADDRESS_______________________________CITY____________ZIP
CODE______
PHONE
(HM)____________________________(WK)___________________________
PROGRAM APPLYING
FOR_________________________
Please state why you feel this program would be beneficial to the child/children you are applying for: ___________________________________________________________________________________
___________________________________________________________________________________
Applicants must provide
proof of financial services through AFDC, Social Services,
We ask that all applicants
pay some portion of the program fee.
What portion of the fee do you feel you could afford? ________.
PARENT/GUARDIAN SIGNATURE DATE
Please complete a registration form and return it
with this application to
Parks & Recreation, 600 Cregg Lane, Missoula,
Montana 59801
Youth program grants are
administered by Shirley Kinsey, Recreation Manager. We will contact you within 3 working days to
advise you of your grant status. Please
call 552-6256 if you have any questions.
OFFICE USE ONLY:
š Approved Program_____________________________________ Fee___________
Amount applicant owes: __________________
Date applicant informed of approval_________ Date Registered_______
š Not approved COMMENTS:
_______________________________________