Financial Assistance | Miami Beach Youth Sp

Participant's First Name

Participant's Last Name

Participant's Birthdate

Participant's Grade

Participant's School

Parent / Guardian Name

Email

Phone

Address

Financial assistance is limited to children who reside in the City of Miami Beach. Please upload two of the following documents showing your current Miami Beach address.

Which program are you requesting financial assistance for?

If you selected “Other amount,” please enter the amount requested.

Is the participant a Miami Beach resident?

yes

no

Please select all that apply to your household and upload the applicable documentation.

Is there anything you would like us to know when considering your request?

I certify that the information provided in this application is true and complete to the best of my knowledge. I authorize MBYSF to verify the information and documentation submitted for purposes of reviewing this financial assistance request. I agree to notify MBYSF if my financial circumstances materially change before assistance is awarded or applied.

Parent / Guardian Electronic Signature

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Date

Month

Day

Year

Please note: Financial assistance is subject to eligibility, available funding and program availability. Approval may cover part or all of an eligible program fee. Additional documentation may be requested.