Scholarship Application

Scholarship Application

Please complete this form if you would like to be considered for financial assistance for BGCVP's After-School Program tuition. Submission of this application does not guarantee the award of financial assistance. All applications will be reviewed based on the information provided and any applicable program criteria. BGCVP reserves the sole right to approve, deny, or determine the amount of any financial assistance awarded. A member of our team will contact you within 5–10 business days regarding the status of your application.
WAIT! Have you created an online membership account?
Please note: Families must complete BGCVP membership registration and create an online account through our registration portal before applying for financial assistance. Returning families must renew their existing membership account. Our registration platform works alongside the scholarship application and collects important information needed to review your request that is not included on the scholarship form. Scholarship applications cannot be considered until the applicant has an active BGCVP membership account. To create a new account or renew your membership, please visit our online registration platform. Once your membership registration is complete, you may submit your scholarship application.

If you have questions or need assistance with the registration process, please contact BGCVP Membership Specialist Ryan Fiorenza at rfiorenza@bagclub.com.
Do you have an active online membership account?
Parent/Guardian Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Family Unit Size
Please include everyone in your household.
Child's Full Name

First NameLast Name
Age
Child's Full Name

First NameLast Name
Age
Child's Full Name

First NameLast Name
Age
Child's Full Name

First NameLast Name
Age
Child's Full Name

First NameLast Name
Age
Joint Annual Household Income
Which BGCVP Unit are you interested in attending?
Partial or Full Financial Assistance Needed
Military? Active or Reserve Only
Briefly describe your financial situation and why you are requesting assistance
Verification of Need

BGCVP is able to provide families who submit this information with fee assistance. Refusal to submit the following information will result in the immediate denial of this scholarship application.
Verification of Benefits or Services (One Required)

Only one form of documentation is needed.
Cancelof
Acceptable Verification of Benefits Include:
- Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Medicaid, and Cardinal Care: Official documentation showing that family/youth is currently receiving benefits at the time of application/enrollement into the Out of Schoool Services Program (Integrated Eligibility System (IES) documentation, Official Letter for the Virginia Department of Social Services outlining the receipt of benefits.
- Supplemental Security Income (SSI): Award letter from the Social Security Administration
- Free or Reduced Lunch: Award letter indentifying free or reduced lunch as established by individual family eligibility. Note: programs may receive a list of students receiving free or reduced lunch, granted the listing is on official school letterhead with the disclaimer that all free or reduced lunch eligibility is determined by individial familiy application. Universal, school-wide, city-wide, or district-wide free lunch does NOT qualify as acceptable point of eligibility for the VADSS Out of School Services.
If unable to provide any of the above listed documentation, you may still be eligible by providing family unit size and yearly household income information to determine eligibility.
I cannot provide the above listed documentation, and will provide additional income information.
If answered yes above, please submit your proof of income.

Examples include: pay stubs for the most recent 4 weeks of earnings, W-2 Forms, quarterly/annual income tax returns, letter/statement from employer, copy of current check with check stubs within the last 4 weeks, social security records, workers' compensation records, and unemployment insurance claim records.
Cancelof

Household Composition and Income (Only complete if applying using proof of income)

Rows	Name (First, Middle, Last)	Relationship	Date of Birth (MM/DD/YY)	Income Source	Amount (Grosss Monthly Income)	How ofter received?
Household Member 1
Household Member 2
Household Member 3
Household Member 4
Household Member 5
Household Member 6
Household Member 7

Gross Monthly Income is income before taxes and deducations.
By signing below and submitting this form, I certify that:
- All the information I have provided in this application is true.
- I promise to cooperate with any effort to verify the information provided.
- If selected to participate in the scholarship program, I promise to abide by all rules and guidelines.
Signature
For questions, please contact Chief Operating Officer, Rob Coleman at (757) 223-7204 or rcoleman@bagclub.com.
Should be Empty:

Scholarship Application

WAIT! Have you created an online membership account?

Verification of Need