Goodwill Scholarship Program Form 2015 printable pdf download

GOODWILL SCHOLARSHIP PROGRAM

RECREATION & AQUATICS

Fiscal Year 2015-2016

City of Chandler Community & Neighborhood Services Department

The City of Chandler Community & Neighborhood Services Department offers a goodwill scholarship program to

provide Chandler residents access to quality recreation and aquatics programs that they may not otherwise be

able to participate in without fee assistance. Please refer to the Break Time brochure for a complete class list and

general information. To apply for the goodwill scholarship program, please complete the fee assistance application

in its entirety and return it to the Chandler Community & Neighborhood Services Department along with your class

registration form and all required financial documentation.

Scholarship Guidelines:

Chandler residents only.

The fee assistance application is valid for the current fiscal year (July 1, 2015-June 30, 2016). Applicants must

re-apply every fiscal year to determine eligibility.

All required financial documentation, proof of residency (i.e. current utility/water bill, property tax statement), and

a completed class registration form must be turned in with the fee assistance application. After initial approval,

only a registration form is required for each class/program/activity stating the fee assistance application is

approved and on file.

Fee assistance is approved based on Maricopa County Annual Income Guidelines, and is not guaranteed.

Fee assistance will not exceed $150 per family, per fiscal year (July 1, 2015-June 30, 2016). Any balance

above the approved $150 must be paid in full at time of registration.

Separate registration forms must be completed and submitted for Recreation and Aquatics classes.

Fee assistance funds do not cover items such as: Red Cross fees, pool admission fees, supply fees, instructor

fees, adult sports fees, excursions, field trips, etc.

A maximum of two (2) fee assisted registrations will be approved for any class, camp or program.

Please allow at least 7-10 business days prior to the upcoming session registration period or class start date for

application processing.

Participants must follow the Recreation or Aquatic Division’s refund / cancellation policy. The Community &

Neighborhood Services Department reserves the right to revoke the goodwill scholarship/fee assistance for

participants who cancel classes excessively or fail to follow the refund/cancellation policy.

All requests for approvals, cancellations or transfers must be turned into the approving Coordinator.

All family members in the household must be noted on the application. Only dependents living in the household

that are listed on the application will be approved to use fee assistance funds.

Financial Documentation – two (2) of the following are required:

A copy of the most recent federal tax return, W-2(s) or 1099(s) for all members living in the household who

receive any form of income.

A copy of the two (2) most recent paycheck or unemployment check stubs for all household members who

receive any form of income.

Approval paperwork from the City of Chandler Housing Division.

A copy of the most recent Social Security or SSI Disability award letter for all household members who receive

this form of income.

SNAP verification, WIC assistance verification, or AHCCCS verification for all household members who receive

this assistance.

DO NOT SUBMIT ORIGINAL DOCUMENTS.

In order to be approved, your family must meet the following income guidelines according to the family

size living in the household :

Maricopa County

Return your completed application and required documents to:

Annual Income Guidelines

Mail:

Family Size

Income

Chandler Community & Neighborhood Services Department

$22,400

P.O. Box 4008

$25,600

Mail Stop 501 (Recreation) or Mail Stop 906 (Aquatics)

$28,800

Chandler, AZ 85244

$32,000

Drop off:

$34.600

Recreation:

125 E. Commonwealth Ave. Chandler, AZ 85225

Aquatics:

650 E. Ryan Rd. Chandler, AZ 85286

$37,150

$39,700

For further information call:

Recreation:

480-782-2710

$42,250

Aquatics:

480-782-2756

See reverse for Fee Assistance Application

Goodwill Scholarship Program Form 2015

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