Parent/Guardian 1 If you are the parent/guardian completing this form, please enter your info here:
This parent/guardian helps to financially support child(ren)
Parent/Guardian 1 Employment Info
You are REQUIRED to self-report your annual income. Income is defined as the total of all the ADULT HOUSEHOLD members’ gross income that is anticipated to be received during the coming 12-month period. Income includes things such as wages, tips, social security payments, alimony, child support, and the income generated by an asset such as bank accounts or a 401(k).
Parent/Guardian 2 This parent/guardian helps to financially support child(ren)
Parent/Guardian 2 Employment Info
If parent/guardian 2 income is INCLUDED in annual household income reported for parent/guardian 1, please check here
Children Info Please enter the names, ages, and birthdates of child(ren) for whom you are seeking an activity scholarship.
Check here if you would like to discuss options for additional children in your family
Program Info Supported programs include summer camp, day camp, sports, music, recreation, arts, academic programs, STEM programs, and other enrichment programs for children. Providers must be recognized by the State of Idaho as a business or nonprofit. Programs must take place in a group or public setting.
Have you identified a program or programs for your child(ren?
What is the program?
Please explain why you have chosen this program and how you believe it would benefit your child(ren) and family.
Can you commit to your child(ren) fully participating and attending every meeting for this program?
Are there portions your child(ren) will miss?
Let us know what you are looking for and we can make a recommendation to meet your needs.
What concerns do you have about making sure that your child can fully participate in all aspects of any program?
Can you pay this in one lump sum or in monthly payments?
How will you transport your child(ren) to the program and ensure that they arrive on time?
Who will drop off the child(ren) and pick the child(ren) up?
Will you be able to provide the equipment and supplies needed for the program, or do you need assistance with that? Please be specific about your needs.
Please review and confirm each item below I understand that my employer will be contacted to verify that I (or one of my child’s parents/guardians) work in the restaurant or hospitality industry and to confirm wages.
I can commit to ensuring that my child fully participates in the program. If I cannot follow through with participation, I will promptly notify both CDAIDE and the program provider.
I understand that CDAIDE’s only role is to pay a portion of the program fees. I know that I will be responsible for registering my child, getting my child to and from the program with appropriate materials/supplies (if applicable), and completing any other roles required of parents or guardians as part of participation.
I can commit to setting aside the parent portion of program fees that I have identified on this form.
In completing this application, I am authorizing CDAIDE to communicate with program providers on my behalf about payment. The program provider will be made aware that my child is receiving a scholarship and CDAIDE may arrange a discount on total fees through the program’s own scholarship program.
I understand that my child will be participating in this program at their own risk. I have the responsibility to examine a program and ensure that it is a safe environment for my child. CDAIDE does not vet programs and makes no claims about the safety of individual programs or providers.
I agree to complete a survey following my child’s participation in the program. I understand this is required in order to receive the scholarship.
SUBMIT
List specific dates of the program you have identified
APPLICATION NOTE: The information provided on this form is subject to verification by HUD at any time, and Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony and assistance can be terminated for knowingly and willingly making a false or fraudulent statement to a department of the United States Government.
I certify that this information is complete and accurate
