Application

Application for Services

Will's Kids strives to maintain the activities of kids whose families need assistance. Applications are reviewed by our Board of Directors and awarded as funds allow. Although we try to help when we can, Will's Kids reserves the right to refuse assistance to any applicant.

Full Name of Child

Date of Birth

Current Age

Name of School

Current Grade

Name of Parent/Guardian

Street Address

City/State/ZIP

Address where Child Lives

Cell Phone

Email

Cell Phone

Email

How many in Household

Monthly Gross Income

We are applying for:

WillPower Program (Ages 12-18)

Will2Win Program (Ages 12-18)

Young Entrepreneurs of America (Ages 16-18)

Toot Your Horn Program (Ages 10-13)

88 Degrees Scholarship (Ages 16-18)

ICanClub Program (Ages 7-12)

Amount Needed

Check one

One-Time Assistance

Ongoing Monthly Assistance

Musical Instrument

Program Provider

Program Instructor

Direct Phone

Direct Email

Website

Why do you need our help?

I certify that the above information is true and complete to the best of my knowledge. I agree to infom Will's Kids of any change to any information provided that may affect my need for assistance. I understand that failure to do so may result in termination of any award given.

Electronic Signature

Date

Thanks for submitting!

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