Strive to Thrive

Stive to Thrive Application

Programs that support Mental Health
All form fields must be filled out completely for your application to be submitted.

Have the following documents on hand before starting this application:
- Proof of income for all parents/guardians who live in the same household must be provided. Acceptable proof is your current CCB (Canada Child Benefit) Your Benefit Notice is provided by the Federal Government annually in July. Visit our program's page on our website to learn how to obtain this form.
- Please be advised that processing of your application may take up to 3 weeks to complete and longer in busier times of the year. If your application is approved funds will be sent directly to the Organization within 2-3 weeks.

Section 1: Participant Information

Applications for children/youth up to age 21 are invited to apply
What county does the participant reside in?*

Hastings CountyNorthumberland CountyPrince Edward County

Child's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Has the participant received funding from The Children’s Foundation in 2025?*

YesNo

Section 3: Parent/Guardian's Information
Parent/Guardian's Name*

First NameLast Name
Address
City
Telephone*
Parent/Guardian Email*
example@example.com
Is there a second parent in the household?*

YesNo
Please provide names of all Parents/Guardians in the household
How many children live in the household?*
If there is more than one child in the household, what age are they?
Add all ages, separated by comma

Section 2: Highland Shores Children's Aid
What is your worker’s name?
If applicable
Worker's email address
example@example.com
Do you currently have an open file involved with the Highland Shores Children’s Aid Society?*

YesNo

Section 2: Qualifying Criteria
Annual GROSS Household income before taxes.*
Per your current Income Tax return for all individuals.
I receive the Canadian Child Benefit or CCB for my children.*

YesNo
Please attach your current CCB (Canada Child Benefit) Benefit Notice. (Acceptable file formats: pdf, jpg, jpeg, png, screenshots) Visit our program's page on our website to learn how to obtain this form.*

Cancelof

Section 4: Organization Information
Organization Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact email*
example@example.com
Contact telephone*
Type of activity*
Start date of activity*

MonthDayYear
Date
Previous funding
This registration is for (pick one)

One session (ie. one program of X number of weeks) or,Ongoing sessions (program runs all year, weekly lessons)Other
Is there anything else you'd like to tell us?
The Children's Foundation is a donor supported Organization. How will this funding impact your child and family positively?*
Chq #
Date

Section 5: Permissions & Signature

Almost done!
I have thoroughly read and understand the guidelines of Strive to Thrive and agree that this application meets the guidelines and is truthful.*

Yes
I give The Children's Foundation permission to contact me for testimonials and impact stories.*

YesNo
Guardian Signature*

Clear
Date signed*

MonthDayYear
Date
If you have any questions about this form, please submit an email to info@thechildrensfoundation.ca
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Stive to Thrive Application