GMSC Financial Assistance Application

GMSC - Financial Assistance

Form filled out Date and time
Parents or guardians of swimmers currently registered with Gold Medal Swim Club may apply for financial assistance. Approval of the application is made on an individual basis based on need and the availability of funding. All information submitted in this form is confidential, and will be reviewed solely by the applicable coaching staff members and management. Failure to complete this form in its entirety may impact your financial assistance. GMSC may request additional documentation in reviewing the information submitted on this form.
Swimmer(s)
Swimmer's First Name (S1)*
Last Name*
Swimmer's First Name (S2)
Last Name
Swimmer's First Name (S3)
Last Name
Family Information
Primary Adult/Guardian’s First and Last Name*
Relationship to Swimmer*
Secondary Adult/Guardian’s First and Last Name
Relationship to Swimmer
If one of the adults above is omitted, why?
Email Address of Primary Adult/Guardian*
Phone Number of Primary Adult/Guardian*
Employment Information
Primary Adult/Guardian’s Employer
Job Title
Full or Part Time
Secondary Adult/Guardian’s Employer
Job Title
Full or Part Time
Financial Information
Combined annual income of Primary and Secondary Adults listed above, as stated on the most recent tax return(s)
Number of dependents claimed on tax return(s)
Statement of Financial Need
Special Circumstances
Are there special circumstances that you would like GMSC to take into consideration? These could include extraordinary family expenses, unemployment, or other financial considerations.
Are you seeking short term or long term financial assistance?*
Do you have multiple students in the program?
Number of swimmers in the program
Amount of Tuition You Feel You Are Able to Pay*
Electronic Signature Affirmation
We aim for our programs to be accessible by all, and seek to eliminate financial resources as a barrier to participation for any swimmer.*
- By submitting this form I affirm that the information in this application is true.
Name
This field is for validation purposes and should be left unchanged.

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GMSC Financial Assistance Application

GMSC - Financial Assistance

Swimmer(s)

Family Information

Employment Information

Financial Information

Statement of Financial Need

Electronic Signature Affirmation