HYLAND HILLS FOUNDATION GRANT APPLICATION-Finale Verison

HYLAND HILLS FOUNDATION GRANT APPLICATION
The Hyland Hills Foundation is a Colorado non-profit corporation established in 1992. One of its missions is to provide assistance to financially disadvantaged young people who could not otherwise participate in the recreation district's programs.
You may apply for a grant if your dependent child lives with you inside the boundaries of Hyland Hills, or is currently attending a Westminster Public School. All grant applications must be completed by a parent or legal guardian. All information received by the Foundation will be kept confidential.
Please call 303-650-7488 or email drohleder@hylandhills.gov if you have questions or need assistance completing your application.
Applicants must apply 7 days prior to program registration deadline. Some programs are not available for Foundation scholarship grants. Please allow 2 - 3 business days for approval of all grant applications.
Upon approval the applicant recieves in their Hyland Hills account, three credits of $75 each to use towards youth programs
Full name of parent(s) or legal guardian(s)
Date

MonthDayYear
Date
Street address of parent or legal guardian

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number
Format: (000) 000-0000.
Email Address
example@example.com
Total household annual income
Household size (total number of people residing in home)
Name of child (complete legal name)
Age of child
Street address of child

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of school child is attending
Grade

Program or class child wishes to attend
Activity #
What benefits will your child obtain by participating in the Hyland Hills program?
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Rows	Copy:	Date:	Staff:
Free/Reduced meal letter
Federal Government Program letter
State of Colorado Program letter
Federal Tax Return (1040 form)
Notes:
Initial Grant Approval
Staff Subsequent Grant Approval

Exp. Date

MonthDayYear
Date
Exp. Date

MonthDayYear
Date
Should be Empty: