Financial Assistance Application

As a non-profit organization we are committed to serving all families despite their ability to pay. Financial assistance is available to cover partial to full cost of groups and programs. If you feel that you cannot afford the cost of our regular fees, please complete an application for financial assistance. Submissions are confidential. 

Name *
Address *
Phone *
Please select the program you are requesting financial assistance for.
Please enter your annual household income.
Please let us know the fee you could afford for the above program or service.
Is there anything else you would like us to know when considering financial assistance?