Bursary for Families

ECFTA CHILDREN & YOUTH
BURSARY APPLICATION FORM

PARENT/GUARDIAN INFORMATION

Parent/Guardian Information *

First name

Last name

Parent/Guardian Email *

Parent/Guardian Phone *

CHILD/YOUTH INFORMATION

Child/Youth Name *

please include first and last name

Age *

Any allergies or medical concerns? *

Any behaviour or learning concerns? *

I give photo permission on behalf of my child. *

if yes, please tick box

Name of individual dropping off and picking up, if other than yourself. *

PROGRAM INFORMATION

Class or Camp Name *

Please view Kids Classes & Camps on our website to find program names.

Class or Camp Date *

BURSARY REQUEST

I/we are experiencing financial need and would like to be considered for a bursary. *

*No proof of income required

I/we request 50% of program fees covered.

I/we request 100% of program fees covered.

CERTIFICATION

I certify that that the information provided is true. *

Type your name (Parent/Guardian) *

Any additional information.