REGISTRATION

Registration - Financial Assistance Request Form

Financial Assistance Request Form

PAL Financial Assistance Application

If you are seeking financial assistance, please complete the form below. There are several assistance levels offered; please select the level that best suits your needs. We are aware that this can be an uncomfortable request, but be assured that all information contained within this application shall be confidential and shall be used for the sole purpose of determining eligibility for financial aid.

Please use the comments section at the bottom of the form to add any additional info.

The PAL is proud of its policy to NEVER turn away a child due to a family's inability to pay.

Name

Address

City, State Zip

Phone

This email address will be used for all PAL correspondence, including evening and weekend information.

Alternate Phone #

Alternate Email

# of PAL Children

Please choose from the assistance levels listed below.
'Sweat equity' levels (full or partial) would be a fee adjustment agreement met by working multiple hours to help maintain the complex and/or via shifts in the Snack Shack.

(Note: as a volunteer organization the PAL requests that all member families participate in the 'sweat equity' component, so this arrangement would only be offered to families that require financial assistance.)

Please use the selections below for comments or information about your circumstances. You can also choose to speak with a PAL Board member privately.

Please list any special circumstances that contribute toward your need for financial assistance

Additional Comments

I'd rather speak with a PAL Board member directly

Please choose from the assistance levels listed below.

'Sweat equity' levels (full or partial) would be a fee adjustment agreement met by working multiple hours to help maintain the complex and/or via shifts in the Snack Shack.

(Note: as a volunteer organization the PAL requests that all member families participate in the 'sweat equity' component, so this arrangement would only be offered to families that require financial assistance.)

Financial Assistance

Partial payment with Sweat Equity trade-off

Full Sweat Equity trade-off

Full Payment via Payment Plan

Full financial assistance required (please explain in comments)

Other (please explain in comments)