CYC Sponsorship Request Form

Camp Fees Sponsorship Request
About the CYC Sponsorship Fund
- The purpose of the sponsorship fund is to help low income families pay for camp fees where they may not qualify for other funding.
- A sponsorship request is required for each enrolment. Please ensure enrolment form has been competed before submitting this request.
Important Information about this Form
- When you complete the form, you will recieve a confirmation email advising you were successful. If this does not appear, your form HAS NOT BEEN SENT and the camp office will not recieve any notification of your request.
- This form has multiple paged, and all pages must be completed for the sponsorship request to be complete. Unfortunately, we cannot process incomplete sponsorship request forms and as a result, your child could miss out on recieving sponsorship.
- All fields marked with a * are required fields.
Camper Details:*

Camper's First NameCamper's Last Name
Name of the camp sponsorship is being requested for:*
Your Details:*

First NameLast Name
Your relationship to the camper:*
E-mail*
This is how we will contact you. Please ensure it is correct.
Phone Number*

eg. 021eg. 123 1234
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you completed an enrolment form for this camp?*

YesNo (please fill one out before completing this form)
Please tell us why you need sponsorship for camp fees:*
Child Disability Allowance
Do any children in your family currently receive the Child Disability Allowance?*

NoYes
Oscar Subsidies

MSD has a new online tool to help families see what might be avaliable to them in the way of financial assistance (including OSCAR subsidies) please visit https://check.msd.govt.nz/ to see if you might qualify for OSCAR subsidies for our camps. Ensure you select yes for the "Do you or your partner pay, or intend to pay, for this child to go to an OSCAR programme, for at least 3 hours a week?" question for each child you are intending to enrol.
Have you ever applied to to work and income for the OSCAR childcare subsidy?*

NoYes
Please apply for OSCAR subsidies by calling Work and Income on 0800 559 009 to arrange an OSCAR form to be sent to you and ask for the request to be put on record then: Complete the form and return it to Work and Income before the camp starts AND Let the CYC office know if you are applying.
Important Information about OSCAR Subsidies
- OSCAR Child-care subsidies are applied based on family income and work/study hours may not cover full camp fees. The balance of any unpaid camp fees will need to be paid by you.
- For more information about OSCAR subsidies and current income rates, please visit: http://www.workingforfamilies.govt.nz/childcare-assistance/
Ministry of Health Carer Support
Has your child ever received Carer Support from the Ministry of Health?*

NoYes
Social Agencies
Is your family associated with or clients of any of the following organisations?*

Strengthening FamiliesAnglican Family CarePresbyterian SupportSalvation ArmyN/A
Is your family associated with or attend a church?*

NoYes
Church Name:
Pastor's Details:

First NameLast Name
Pastor's Email:
example@example.com
Pastor's Phone Number

eg. 021eg. 123 1234
Family Income Details
What is your families weekly income after tax?*
Is anyone in your household on a benefit and if so, which one?*
Please tell us the number of people in your household who are living off this income*

AdultsTeenagers
Children and Infants
How much can you afford to pay towards the camp fees so that the sponsorship fund can benefit more?*
Declaration

I declare that the supplied information is correct and accurate to the best of my knowledge. I understand that the supplied information will be used by CYC Waihola for the allocation of sponsorship funds only. It will be kept on file for auditing purposes even after the camp has past. Financial Situation Information will be kept confidential to CYC Waihola staff for the purposes of allocating sponsorship funds fairly. Other supplied information maybe used to approach agencies such as churches and support organisations for assistance on your behalf for the sponsorship of camp fees. I, being the parent or legal guardian of the Camper, by pushing submit agree to the above declaration.
Should be Empty:

Camp Fees Sponsorship Request

About the CYC Sponsorship Fund

Child Disability Allowance

Oscar Subsidies

Please apply for OSCAR subsidies by calling Work and Income on 0800 559 009 to arrange an OSCAR form to be sent to you and ask for the request to be put on record then: Complete the form and return it to Work and Income before the camp starts AND Let the CYC office know if you are applying.

Ministry of Health Carer Support

Social Agencies

Family Income Details

Declaration