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  • Confidential Financial Assistance Application

    Important Information -- Please read before completing.

    • Only complete applications with the required documentation submitted will be reviewed.
      Awards are made annually when funding is available. 
    • To be considered for financial assistance for Nierman Preschool or Camp Jaycee, your child must be registered in preschool or camp prior to applying for financial assistance. 
    • International students are not eligible to apply for financial assistance. 
    • Financial Assistance is intended to cover a portion of the fees, not 100%
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  • Applicant Information

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  • Dependents

  •       Relationship to Applicant:   Date of Birth:            Requesting Financial Assistance:         

  •       Relationship to Applicant:   Date of Birth:           Requesting Financial Assistance:         

  •       Relationship to Applicant:   Date of Birth:           Requesting Financial Assistance:        

  •       Relationship to Applicant:   Date of Birth:            Requesting Financial Assistance:         

  • Monthly Income Sources

  • Monthly Expenses

    Please include expenses that are“unusual” for your family, such as medical expenses, living expenses, or support that is given to family members who are not your legal dependents.

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  • Confirmation of Data Provided

  • Your signature below indicates that: 

    I, the undersigned, understand that the information I provide must be accurate and verifiable.  I agree to provide any additional information that the JCC reasonably requests, and to allow the JCC to make such reasonable inquiries as it deems necessary in this regard, including without limitation, to banking institutions and credit reporting agencies. 

    I understand that if any of the foregoing information is inaccurate, the JCC may take appropriate action at its sole discretion, including without limitation, the withdrawal of any Financial Assistance, and the suspension or revocation of my membership. 

    In addition, I acknowledge that in the event that my Financial Assistance is withdrawn, but my membership privileges are still extended by the JCC, I will be expected to pay the balance of the prevailing membership fee or will forfeit my membership.

    Finally, I understand that I am submitting sensitive information over a secure server and that my application will be handled with care and confidentiality.

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