Program Fee Assistance Application
Please enter the Scout's Information for this application. This form must be filled out by a family member of the Scout applying for assistance.
Scout's Name (Nombre del Scout)
*
First Name (Primer)
Middle Name
Last Name (Apellido)
Unit Type (tipo de unidad)
*
Please Select
Pack
Troop
Crew
Ship
Post
Unit Number (numero de la unidad)
*
Unit Leader Name (nombre del lider)
*
Unit Leader E-mail (email del lider)
*
Contact e-mail for application results or questions. (email por preguntas o resultados)
*
Mobile number of parent (telefono de los padres)
*
Format: (000) 000-0000.
Address of Scout (direccion del Scout)
*
Street Address (calle)
Street Address Line 2
City (ciudad)
State / Province (estado)
Postal / Zip Code (codigo postal)
Have you received assistance before such as a "campership" with the Council? (Has recibido ayuda antes del consejo?)
*
Please Select
Yes (Si)
No
Total household annual income (ingreso familiar anual total?)
*
$
Father's occupation (trabajo del padre?)
*
Name of Father's employer (nombre del empleador del padre?)
*
Mother's occupation (trabajo de la madre?)
*
Name of Mother's employer (nombre del empleador del madre?)
*
Number of children in household (cuantos ninos hay en el hogar?)
*
Total number of individuals in household (cuantos personas hay en el hogar?)
*
Will the Scout participate in "Popcorn Sale" in fall? (El Scout vendio los palomitas en el otono?)
*
Please Select
Yes
No
Will the Scout participate in the "Adventure Card Sale" in the spring? (El Scout vendera los "Adventure Cards" en la primavera?)
*
Please Select
Yes
No
Why are you requesting assistance? Briefly describe the circumstances, financial need, family medical bills, unemployment, etc. (Por que necesitas ayuda?)
*
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