Summer Day Camp Application
To register for assistance, please complete this form to the best of your ability.
All of this imformation is necessary to determine eligibility for assistance.
Date of Birth
Last 4 Digits of Social Security Number
Are you a Veteran
Does not Identify
Source of Income
SSI, GA, or TANF
Child or Spousal Support
Staying with Friends & Family
Court/Written Notice from Landlord
I would like to enroll my child in:
Session 1 (children ages 6-8) Dates: (July 6th-July 17th)
Session 2 ( children ages 8-10) Dates: ( July 20th-July 31st)
Session 3 ( children ages: 10-12) Dates: ( August 3rd-August 14th)