Neighbors in Hardship Scholarship Application : How To Help : Boys & Girls Clubs of Northwest New Jersey

The Boys & Girls Clubs of Northwest New Jersey is committed to providing safe, inclusive, high-quality, and affordable programming for all families. If you need assistance to help pay for your child’s program, please fill out the form below. Once you submit your application, the BGCNWNJ Administration will review your application and follow up within 14 business days.

UNIT: (Wayne or Pequannock Unit)

Program you are requesting & site location (after-school, summer camp, daycare, etc. and site location. Example...N Haledon, Kinnelon, etc.) (Required)

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Please select the option that best describes your circumstance

If Denied: Please download Denial Letter

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Contact Information

Member First Name (Required)

Member Last Name (Required)

Member Date of Birth (Required)

Ethnicity (Required)

Member's Gender

Address (Line 1)

Address (Line 2)

City

State

Zip

Phone

Email (Required)

School and Household Information

Members Current Grade (Required)

Number in Household (Required)

Are you a currently a single parent?

Annual Household Income (Required)

How much are you able to pay BGCNWNJ weekly? (Required)

Custody and Guardian Information: Please include the contact information for the member's legal guardian

Guardian One

Full Name (Required)

Relationship to Member (Required)

Employer (Required)

Phone Number (Required)

Contact Email (Required)

Guardian Two

Full Name

Relationship to Member

Employer

Phone Number

Additional Information

Please check the box next to any of the listed programs that you qualify for

Pension (Includes veterans)
Any Social Security
Unemployment
Workmans comp or Disability
Alimony
Child Support
Other Income

Please list the programs you checked above with amounts awarded for each.

Please describe the reason you are applying for a Neighbors in Hardship Scholarship in as much detail as possible. (Required)

How did you find out about the Neighbors In Hardship Scholarship Fund?

Upload Most Recent W2 (Required)

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Upload Most Recent Income Tax Return (Required)

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Upload Two Recent Paystubs (Required)

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Upload Additional Supporting Documents

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Confirm below

Yes, I understand that I must comply with all requirements, status updates and complete periodic surveys regarding how the scholarship benefits my child & family to receive the scholarship. This information, requested by our funders, remains confidential.