Racine Zoo Lil’ Explorers Preschool Women United Financial Assistance Application
Thank you for your interest in Lil' Explorers! Our goal is to welcome all audiences to our organization. Please provide the below information to be eligible to receive financial assistance.
Full name of guardian
*
First Name
Last Name
Primary phone
*
Please enter a valid phone number.
E-mail:
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Full name of child
*
First Name
Last Name
Age of child
*
Full name of additional child (if applicable)
First Name
Last Name
Age of additional child (if applicable)
Full name of additional child (if applicable)
First Name
Last Name
Age of additional child (if applicable)
Do you receive any form of government or public assistance through programs such as SNAP/Food Share, Medicaid/BadgerCare, WIC, energy assistance, or free/reduced lunch?
*
Please Select
Yes
No
Please upload proof of receipt of government or public assistance.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
What is the average monthly income of your household?
*
Are you applying for financial assistance to register a child who is currently in the foster care system?
*
Please Select
Yes
No
Submit
Should be Empty: