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City of Campbell Financial Assistance Application 2021

  1. Recreation youth scholarships are available to Campbell residents ages 0-17 or students currently enrolled at Rosemary Elementary School. You must complete the online form below and upload required documents before your application can be processed.
  2. Parent/Guardian Contact Information
  3. Currently enrolled for 2020-2021 school year.
  4. Currently enrolled for 2020-2021 school year.
  5. Currently enrolled for 2020-2021 school year.
  6. Currently enrolled for 2020-2021 school year.
  7. I certify that the above information is true and correct and I understand that the information provided here will be relied upon for purpose of determining our eligibility to receive financial assistance from the City of Campbell Recreation & Community Services Department and tha t any misstatement, fraudulently or negligently made in this or in any other statement by me may result in the denial of my eligibility to receive financial assistance. I authorize the City of Campbell to verify the above information. I agree to provide additional documentation to verify my need if requested.
  8. Information
  9. File Upload
    ***Proof of Residency and Proof of Income is required for your application to be processed.
  10. Provide one of the following for residency verification: 1. Copy of Driver’s License or State Identification. 2. Last three months of utility bills
  11. Provide one of the following: 1. Proof from the school district that your child is eligible for free or reduced price meals. 2. Proof that your family is receiving Food Stamps, CalWORKS assistance (California Work Opportunity & Responsibility to Kids), TANF (Temporary Aide to needy families), or Kin-GAP (Kinship Guardian Assistance Payments). 3. If you do not have either of the above, a copy of your last Federal Income Tax Return (form 1040/1040EZ/1040NR) showing that you fall under the income eligibility Guidelines. Your household size must equal the number claimed on your income tax form.
  12. ***Required for Rosemary Elementary students ONLY. Provide all of the following: 1. Letter of 2020-2021enrollment from the school. 2. School district free or reduced lunch award letter.
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  14. This field is not part of the form submission.