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Financial Aid Application

Please complete AS MANY FIELDS AS POSSIBLE.

 

If you have any questions while filling out this form, please contact Tammy Ruder by email or (913) 981-8878.

 

Applications for Membership Financial Aid are applicable to annual Memberships only. Please note, there will be a $25* application fee assessed upon completion of Membership enrollment.

Non-Members, please contact Bobby Carrico by email or (913) 981-8802 to process your membership application.

 

*The $25 application fee is only charged to new members, not recurring members. This fee will be applied to your first month's bill once the application and Financial assistance are completed. This fee does not affect those applying for financial aid for the Child Development Center or for J Camp.

Demographic Information
Type of Financial Aid required:
 Membership
 Child Development Center - Full Time
 Child Development Center - Part Time
 After-School (*See next question)
 Camp
 Para
If applying for After-School Program assistance, please indicate the number of days enrolled (2, 3, 4, or 5)
Head of Household Name
Head of Household Email
Marital Status
 Single
 Married
 Divorced
 Separated
 Widowed
Address
Address 2
City
State
Zip
Phone
Spouse or Domestic Partner Name
Spouse or Domestic Partner Email
Are you a member of a synagogue?
 Yes
 No
Occupation of Applicant (Business Name)
Business Address of Applicant
Occupation of Spouse or Partner (Business Name)
Business Address of Spouse or Partner
Please explain why you are applying for assistance.
Do you have children or other dependents living at your home?
 Yes
 No
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