Financial Aid Request

Financial Aid Request

Lexington Recreation & Community Programs | Lexington Human Services
Financial Aid Request Procecure
1. Financial Aid is available to qualified Lexington Residents only.
2. Many programs and services maintain waitlists, please submit your request allowing adequate time prior to the start of a program for availability, processing, and approval of your request.
3. Financial Aid requests may be submitted in person or online by completing the Financial Aid Request Form.
4. We use LIHEAP (Low Income Home Energy Assistance Program) to determine eligibility (further information may be found at mass.gov). All financial aid awards are based on individual circumstances and available funding.
5. A Recreation staff member will complete a confidential Financial Needs Assessment with the applicant and recommend determination for award.
6. Required documents to submit include:
  1. Financial Aid Request
  2. Verification of household income (see below for examples of what this may include).
7. A confirmation email will be sent from a Recreation staff person with the amount of aid awarded, any balances that may remain and any necessary program forms that may be required for participation.
Any questions regarding the Financial Aid process shall be directed to recdept@lexingtonma.gov

Attendance Policy

We request that any days a participant may be absent or late be shared with the program by emailing recdept@lexingtonma.gov. If you need to cancel participation, please notify us 14 days in advance, as many of the programs maintain wait lists. Multiple absences or no-shows without notice may impact eligibility for future participation.
Examples of household income verification include but are not limited to the following:
- Most recent income tax return
- Wages/Salaries/Tips
- Strike Benefits
- Unemployment Compensation
- Worker's Compensation
- Income from Self-Owned Business/Farm
- Pensions/Retirement/Social Security
- Supplemental Security Income
- Retirement Income
- Welfare/Public Assistance Payments
- Veterans Payments
- Alimony/Child Support Payments
- Disability Benefits
- Cash Withdrawn from Savings
- Interest/Dividends
- Income from Estates/Trusts/Investments
- Net Royalties/Annuities
- Net Rental Income
- Any other Income
Please upload any of the above documents (only required once per year)

Cancelof
Applicant Information
Applicant Name

First NameLast Name
Applicant Gender
Applicant Date of Birth

MonthDayYear
Date
Relationship to participant(s)
Please specify relationship to participant(s)
Relationship to participant(s) (OLD)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Applicant's Signature

Participant & Program Information

Apply for financial aid for individual participant registration in particular programs
How many participants are you registering?
- Name
  
  First NameLast Name
- Gender
- Date of Birth
  
  MonthDayYear
  Date
- School
- Grade Level
- T-Shirt Size
- Is the Participant under 18 years of age?
- Does the participant have any allergies?
- Does the participant take any medications that may need to be administered?
- Would the applicant like to request inclusion services for this program due to a disability, medical or life condition?
- How many programs are you registering this participant for?
- Program #1 Name
- Program #1 Fee
- Program #1 Start Date
  
  MonthDayYear
  Date
- Program #1 End Date
  
  MonthDayYear
  Date
- Program #1 Day of Week
- Program #1 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #2 Name
- Program #2 Fee
- Program #2 Start Date
  
  MonthDayYear
  Date
- Program #2 End Date
  
  MonthDayYear
  Date
- Program #2 Day of Week
- Program #2 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #3 Name
- Program #3 Fee
- Program #3 Start Date
  
  MonthDayYear
  Date
- Program #3 End Date
  
  MonthDayYear
  Date
- Program #3 Day of Week
- Program #3 Time
  
  Hour Minutes
  
  AM/PM Option
- Name
  
  First NameLast Name
- Gender
- Date of Birth
  
  MonthDayYear
  Date
- School
- Grade Level
- T-Shirt Size
- Is the Participant under 18 years of age?
- Does the participant have any allergies?
- Does the participant take any medications that may need to be administered?
- Would the applicant like to request inclusion services for this program due to a disability, medical or life condition?
- How many programs are you registering this participant for?
- Program #1 Name
- Program #1 Fee
- Program #1 Start Date
  
  MonthDayYear
  Date
- Program #1 End Date
  
  MonthDayYear
  Date
- Program #1 Day of Week
- Program #1 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #2 Name
- Program #2 Fee
- Program #2 Start Date
  
  MonthDayYear
  Date
- Program #2 End Date
  
  MonthDayYear
  Date
- Program #2 Day of Week
- Program #2 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #3 Name
- Program #3 Fee
- Program #3 Start Date
  
  MonthDayYear
  Date
- Program #3 End Date
  
  MonthDayYear
  Date
- Program #3 Day of Week
- Program #3 Time
  
  Hour Minutes
  
  AM/PM Option
- Name
  
  First NameLast Name
- Gender
- Date of Birth
  
  MonthDayYear
  Date
- School
- Grade Level
- T-Shirt Size
- Is the Participant under 18 years of age?
- Does the participant have any allergies?
- Does the participant take any medications that may need to be administered?
- Would the applicant like to request inclusion services for this program due to a disability, medical or life condition?
- How many programs are you registering this participant for?
- Program #1 Name
- Program #1 Fee
- Program #1 Start Date
  
  MonthDayYear
  Date
- Program #1 End Date
  
  MonthDayYear
  Date
- Program #1 Day of Week
- Program #1 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #2 Name
- Program #2 Fee
- Program #2 Start Date
  
  MonthDayYear
  Date
- Program #2 End Date
  
  MonthDayYear
  Date
- Program #2 Day of Week
- Program #2 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #3 Name
- Program #3 Fee
- Program #3 Start Date
  
  MonthDayYear
  Date
- Program #3 End Date
  
  MonthDayYear
  Date
- Program #3 Day of Week
- Program #3 Time
  
  Hour Minutes
  
  AM/PM Option
- Name
  
  First NameLast Name
- Gender
- Date of Birth
  
  MonthDayYear
  Date
- School
- Grade Level
- T-Shirt Size
- Is the Participant under 18 years of age?
- Does the participant have any allergies?
- Does the participant take any medications that may need to be administered?
- Would the applicant like to request inclusion services for this program due to a disability, medical or life condition?
- How many programs are you registering this participant for?
- Program #1 Name
- Program #1 Fee
- Program #1 Start Date
  
  MonthDayYear
  Date
- Program #1 End Date
  
  MonthDayYear
  Date
- Program #1 Day of Week
- Program #1 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #2 Name
- Program #2 Fee
- Program #2 Start Date
  
  MonthDayYear
  Date
- Program #2 End Date
  
  MonthDayYear
  Date
- Program #2 Day of Week
- Program #2 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #3 Name
- Program #3 Fee
- Program #3 Start Date
  
  MonthDayYear
  Date
- Program #3 End Date
  
  MonthDayYear
  Date
- Program #3 Day of Week
- Program #3 Time
  
  Hour Minutes
  
  AM/PM Option
- Name
  
  First NameLast Name
- Gender
- Date of Birth
  
  MonthDayYear
  Date
- School
- Grade Level
- T-Shirt Size
- Is the Participant under 18 years of age?
- Does the participant have any allergies?
- Does the participant take any medications that may need to be administered?
- Would the applicant like to request inclusion services for this program due to a disability, medical or life condition?
- How many programs are you registering this participant for?
- Program #1 Name
- Program #1 Fee
- Program #1 Start Date
  
  MonthDayYear
  Date
- Program #1 End Date
  
  MonthDayYear
  Date
- Program #1 Day of Week
- Program #1 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #2 Name
- Program #2 Fee
- Program #2 Start Date
  
  MonthDayYear
  Date
- Program #2 End Date
  
  MonthDayYear
  Date
- Program #2 Day of Week
- Program #2 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #3 Name
- Program #3 Fee
- Program #3 Start Date
  
  MonthDayYear
  Date
- Program #3 End Date
  
  MonthDayYear
  Date
- Program #3 Day of Week
- Program #3 Time
  
  Hour Minutes
  
  AM/PM Option
- Name
  
  First NameLast Name
- Gender
- Date of Birth
  
  MonthDayYear
  Date
- School
- Grade Level
- T-Shirt Size
- Is the Participant under 18 years of age?
- Does the participant have any allergies?
- Does the participant take any medications that may need to be administered?
- Would the applicant like to request inclusion services for this program due to a disability, medical or life condition?
- How many programs are you registering this participant for?
- Program #1 Name
- Program #1 Fee
- Program #1 Start Date
  
  MonthDayYear
  Date
- Program #1 End Date
  
  MonthDayYear
  Date
- Program #1 Day of Week
- Program #1 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #2 Name
- Program #2 Fee
- Program #2 Start Date
  
  MonthDayYear
  Date
- Program #2 End Date
  
  MonthDayYear
  Date
- Program #2 Day of Week
- Program #2 Time
  
  Hour Minutes
  
  AM/PM Option
- Program #3 Name
- Program #3 Fee
- Program #3 Start Date
  
  MonthDayYear
  Date
- Program #3 End Date
  
  MonthDayYear
  Date
- Program #3 Day of Week
- Program #3 Time
  
  Hour Minutes
  
  AM/PM Option

Membership Information

Apply for financial aid for individual or family membership registrations
Are you applying for financial aid for a membership registration as well?
Which membership(s) are you applying for?
Which membership type are you applying for?
Name

First NameLast Name
Gender
Date of birth

MonthDayYear
Date
List your household members to include on the family membership (with genders and dates of birth)
Example: John Smith, Male, 02/10/1997
Should be Empty:

Financial Aid Request

Financial Aid Request Procecure

Attendance Policy

Examples of household income verification include but are not limited to the following:

Applicant Information

Participant & Program Information

Membership Information