North Perth Sports for Kids Fund GUIDELINES - Listowel Central ...

Name of Child:
Please read the North Perth Recreation Fund GUIDELINES prior to applying.
Birthdate: D/M/Y: Male Female
Parent/Guardian Name(s):
Resident Address:
City:
Postal Code:
Phone:
Name of Program or Activity:
Name of Organization
providing the Activity:
Organization Mailing
Address:
City:
Postal Code:
Start Date:
End Date:
Registration Fee: $
Other related costs if financial
support needed (travel costs,
equipment):
Total Request from the North
Perth Recreation Fund:
$
$
Have you previously received funds from NPRF?
YES NO
if YES, what year(s)? ___________
Experiencing Financial Hardship. I understand that I may be required to verify my family net income.
OR
Special Family Circumstance (please provide a brief explanation below):
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Parent/Guardian Signature:
Information on this application is only used to determine eligibility and will not be shared.
For Office Use Only
Authorization:
Date:
Payment Made:

North Perth Sports for Kids Fund GUIDELINES:
The purpose of the North Perth Sports for Kids Fund (NPSKF) is to assist children and youth who are unable to
participate in physical activities because of financial hardship.
What is the NP Sports for Kids Fund?
• It is a fund which helps families with the cost of fees, special clothing, and equipment, so their children can
participate in healthy physical activities.
• A maximum of $500 per child is available per year.
• Limit of 1 bike every 3 years per individual.
Who is eligible?
• Funding is intended for those whose families do not have access to any other funding programs (i.e. Jump Start,
Ontario Works, City of Stratford Subsidy, Family and Children Services)
• Children and youth (aged 4 to 18) whose family net income is under $55,000 per year (as per Revenue Canada
income tax return) OR
• Children and youth whose families are dealing with special family circumstances (such as recent financial hardship,
family illness, large family size, family crisis)
• Must either be a resident of North Perth or the Program must be located in North Perth
• Funding is available for members of the same family for the same activity or for different activities in the
same season.
What does it pay for?
• Funds may be provided to help with the cost of participating in sport and recreation programs in North Perth.
Travel expenses may be considered on an individual basis. Complete or partial funds may be issued.
How to apply?
1. Please use this application form to apply. Forms are available at Listowel Salvation Army, North Perth Public
Libraries & Arenas, Huron Perth Family Services, Big Brothers Big Sisters of Listowel & District, Municipality
of North Perth, North Perth Chamber of Commerce, Local Schools and Minor Sport Organizations or online at
www.northperth.ca
2. Call or take the application to the Salvation Army at address below. Upon approval, they will issue you a voucher
3. Submit the voucher to the organization
4. Upon receiving a voucher, the organization will send an invoice, in the amount specified, to the address below.
One invoice must be submitted for each voucher
• Verification of your family net income or other family circumstances may be required.
• The North Perth Sports for Kids Program may request references from Social Worker, Teacher or Pastor
• Applications may be submitted at any time
• Applicants will be informed of decision as soon as possible
Can donations be made to this program?
• Yes. The funds are built from financial donations from the community including service clubs, organizations and
individual citizens.
• Donations can be made to the North Perth Sports for Kids Fund by contacting the Stratford and Perth County
Community Foundation (519-271-1503) at 55 Lorne Avenue East, Stratford, Ontario, N5A 6S4 or online
www.spccf.ca
Please send/drop off application forms to:
North Perth Sports for Kids Fund
625 Main Street East
Listowel, ON N4W 2C8
For further information call 519-291-2900