Annual Membership Scholarship Application

Scholarship Application for Annual Family Membership
The Children’s Museum of Richmond is pleased to offer Scholarship Annual Memberships to those families whose household income is less than $44,360 per year, or families that qualify for Virginia SNAP benefits. The Scholarship Annual Membership is made possible through the generosity of friends who support the Children’s Museum Scholarship Fund.

The Children’s Museum Scholarship Annual Membership qualifications are determined by household income, not individual income. To apply for the Scholarship Annual Membership, at least one of the following documents is required from all members of the household who are 18 years of age or older and who cannot be claimed as dependents on your most recent tax return. Any documentation provided must be from the current tax year.

Qualifying documents include one of the following:
- The first page of your current tax return
- Second page of your SNAP benefits approval letter, EBT card, or WIC card
- Verification form from approved partner indicating your scholarship eligibility
APPROVED APPLICATIONS MAY TAKE UP TO 10 BUSINESS DAYS TO BE PROCESSED. APPLICATIONS WITHOUT THE REQUIRED, SUPPORTING DOCUMENTATION WILL NOT BE REVIEWED OR PROCESSED.

Scholarship Family Memberships include:
- Unlimited Admissions for 2 Adults and up to 6 Children in the same household
- Early Registration for Events & Programs
- Members Only Hours
- 10% Off Gift Shop Purchases
- 10% Off Birthday Parties
- 10% Off Baby Showers
- Special Members Only Preview for New Exhibits
- ACM Reciprocal Membership
- PassPlay Rewards Program Access
General Information
Adult Name*
Adult Name
Full Address*
Phone Number*
Email Address*
Please list all of the children living in your household under the age of 18 who will be on your Annual Membership. Include the name, relationship, and date of birth for each child:*
*Add-ons like the Named Additional Adult and Guest Pass are not permitted with scholarship memberships.
Please select the county in which you reside:*

Richmond CityChesterfieldHenricoOther
How did you hear about the scholarship application?*
Upload your qualifying document here, which includes one of the following:
1. The first page of your current tax return
2. Second page of your SNAP benefits approval letter, EBT card, or WIC card
3. Verification form from approved partner indicating your scholarship eligibility
*See below to complete partner verification
Cancelof
Online Signature*
Date*

MonthDayYear
Partner Verification of Eligibility

[To be completed only by community partner organizations.]
I verify that the applicant meets the Children's Museum of Richmond scholarship membership eligibility criteria of household income below $44,360 per year.

I agree
Partner Contact Information
Organization Name
Full Name
Job Title
Email Address
Phone Number
Date

MonthDayYear
Date
Please contact scholarships@cmorva.org with additional questions.
Should be Empty:

Scholarship Application for Annual Family Membership

General Information

Partner Verification of Eligibility