Financial Support

Dear Girls Inc. Families:

Girls Inc. of Worcester is committed to eliminating barriers and providing fair and equitable access to gender responsive programming. We hope to provide affordable, quality programming for all girls. Effective September 2021, we will be offering a sliding scale financial assistance program based on the following tiers. We will no longer be asking for financial documentations. Please fill out the following revised financial support application.

PLEASE NOTE: THE FINANCIAL APPLICATION IS NOT THE SAME AS PROGRAM REGISTRATION. CLICK BELOW FOR PROGRAM REGISTRATION.

PROGRAM REGISTRATION

All Information will be KEPT CONFIDENTIAL!

With questions or concerns, please contact Marielys Rodriguez, or call 508-755-6455.

Please note: any field below with a red star (*) is required to submit this form.

Financial Aid Options: Choose a tier below
Tier	Family of 2	Family of 3	Family of 4	Family of 5	Family of 6
1	$38,000+	$46,500+	$55,000+	$64,000+	$73,000+
2	$23,000-38,000	$23,000-$46,500	$27,000-$55,000	$31,000-$64,000	$36,000-$73,000
3	$0-$23,000	$0-$23,000	$0-$27,000	$0-$31,000	$0-$36,000

1 Start 2 Complete

Parent/Guardian's First Name *

Parent/Guardian's Last Name *

Address *

Country *

Address 1

Address 2

City

State

ZIP code

Preferred Phone Number *

Alternative Phone Number

Email *

Child's First Name *

Child's Last Name *

Child's Date of Birth *

Month

Day

Year

Second Child's First Name

Second Child's Last Name

Second Child's Date of Birth

Month

Day

Year

Third Child's First Name

Third Child's Last Name

Third Child's Date of Birth

Month

Day

Year

Fourth Child's First Name

Fourth Child's Last Name

Fourth Child's Date of Birth

Month

Day

Year

Tier *

Select a financial tier for financial assistance.

I Certify *

I certify that the above information is true and complete to the best of my knowledge. I understand that this does not complete my child's registration process.

Yes

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Financial Support