ON – Outdoor Experience Financial Assistance – Unit Activity Application

This form is for caregivers who wish to apply for financial assistance for their child/ward to engage in activities outside of typical unit meetings that include 80% of programming in an outdoor environment. Your child/ward’s Unit Guider will define for you whether or not an activity is eligible for this program.
Caregivers will be notified of the outcome of their application. Full details and eligibility are defined on our Financial Assistance page.
Personal Information
Girl Name*
First Last
iMIS number
Caregiver applying*
First Last
Email*
Enter Email Confirm Email
Postal Code*
Postal Code
Location*
Please type each girl’s name and membership (IMIS) ID, if known. All the names must appear so that the approved financial assistance amount can be allocated to each girl.
How many girls are you applying for subsidy for?
Child/ Ward Name #1
First Last
Membership (iMIS) ID
Child/ Ward Name #2
First Last
Membership (iMIS) ID
Child/ Ward Name #3
First Last
Membership (iMIS) ID
Child/ Ward Name #4
First Last
Membership (iMIS) ID
Child/ Ward Name #5
First Last
Membership (iMIS) ID
What is your estimated gross (before tax) annual family income?*
Please include all income sources from all caregivers.
What is your estimated gross (before tax) annual family income?*
Please include all income sources from all caregivers.
What is your estimated gross (before tax) annual family income?*
Please include all income sources from all caregivers.
What is your estimated gross (before tax) annual family income?*
Please include all income sources from all caregivers.
What is your estimated gross (before tax) annual family income?*
Please include all income sources from all caregivers.
How many family members live in your home (including yourself)?*
Do you reside in a territory, reserve or fly-in community?*
- Yes
- No
Do you receive disability or income assistance?*
- Yes
- No
Reason for financial assistance*
Unit and Activity Information
Unit Name*
i.e. 22nd Ottawa Embers
Guider Name
First Last
Name of Activity*
Start Date of Activity*
Applications must be received at least four weeks before the scheduled start date in order to allow time for processing
MM slash DD slash YYYY
Cost of activity (before HST)*
Caregiver agreement*
I understand that this program is only to be used by families who would not otherwise be able to attend this activity due to lack of funds. I agree to accept financial responsibility for the remainder of my child/ward’s fee. I understand that if my child/ward’s Unit Guider indicates that the activity is not eligible for assistance through this program that my application may be canceled. I understand that adult members in my child/ward’s unit may be informed about the results of my application.
- I agree
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