Foundation Assistance Application Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Adult names in household * Name and date of birth for each child in your home * Which program(s) are you applying for? * Group Swim Lessons Private Swim Lessons Base Camp (Pre-Swim Team) Swim Team Other If applying for swim camp, please list the dates and times (AM or PM) you would like your swimmer(s) to attend: Annual household income * $ What you are able to afford per month for swim? * Your answer will not affect your chances for being approved for assistance. $ Is your family currently involved in one of PPAF's partner programs? Check all the apply? CPCD Big Brothers Big Sisters Friends of the Children Boys and Girls Club Brad's House CASA Is your family eligible for the school lunch program or any other government assistance? * Yes No Your application has been submitted. We will be in touch with you soon.
