Application Form Step 1 of 2 - APPLICANTS INFO: 50% APPLICANTS INFO:Applicants Name:*Town of Residence:Date of Birth:Parent or Guardian Name:Email (Required):* Telephone Number (Required):*ORGANIZATION INFO:Organization Name:*Contact Name:Email (Required):* Telephone Number (Required):*Organization Address: Street Address Town Postal code ACTIVITY INFO:Activity:Start Date:End Date:Registration Cost: $Equipment Cost: $To make sure HTKP can support as many children as possible, what % of the cost could you pay?0%25%50%75%FUNDING INFO:Parent or Guardian are financially unable (Yes/No/Unsure):Parent/Guardian Signature:Additional Comments (Required):*Please include financial reasons why your child should be considered.Consent/Confirmation (Required):* I consent to having Help the Kids Play store my submission in order to apply to the program. I confirm that I have accurately portrayed my financial situation. Help the Kids Play - Application form Chairperson: Tim Osmond timo@helpthekidsplay.ca 416-951-7157 6825 3rd Line, Tottenham ON, L0G 1W0 Application NumberDate of Application Date Format: DD dash MM dash YYYY EmailThis field is for validation purposes and should be left unchanged.
