SOUTH BRUNSWICK TOWNSHIP PARKS AND RECREATION DEPT.
APPLICATION FOR TUITION ASSISTANCE FOR PARKS AND RECREATION DEPT. PROGRAMS AND CAMPS
RETURN completed application and required documentation to PARKS AND RECREATION DEPT., PO Box 190, Mon. Jct., NJ 08852
Email: recreation@sbtnj.net ; Fax 732 821 2811; Phone: 732 329 4000, x 7671 with questions.
All information contained on this application shall be held strictly confidential. It shall be used only by Parks and Recreation Director to
determine eligibility and registration fees. Application and documentation is due upon registration; fees are due within 2 weeks of approval of
assistance. All applicants must be permanent residents of South Brunswick Township.
1. Person completing Form: First name ________________________Last name___________________________________
2. Address_____________________________________________Town____________________________zip___________
3. Relationship to registrant: ParentLegal Guardian Grandparent Self Other____________________
4. Preferred Phone: Cell Home _________________________ Email address:______________________________
5. Do registrants live at the above address? Yes No if no list address:_______________________________________
6. You must submit: a copy of previous year’s IRS 1040 or 1040A form, or W2 and a copy of 1 month’s of most recent pay stubs.
7 . I certify that the information provided is a true statement of my household’s financial condition.
Applicant’s Signature______________________________________Date of application______________
8. PROGRAM REGISTRANT
FIRST NAME, LAST NAME
AGE /
GRADE
PROGRAM APPLYING FOR
PROGRAM FEE:
A
B
C
9. A. Amount you feel you can afford to pay: $ 9 B. TOTAL COST:
*Gross earnings are before any deductions are taken.
11. INCOME INFORMATION <---------MONTHLY INCOME FROM ALL SOURCES- ALL ADULT FAMILY MEMBERS--------
List name of every adult over age
21 living in household
*Gross
earnings
Job #1
*Gross
earnings
Job #2
Pension,
Soc. Security,
retirement
Any Other
income
Total amt:
A
B
C
11D. TOTAL HOUSEHOLD MONTHLY INCOME FROM ALL SOURCES:
12. TOTAL # IN HOUSEHOLD ______ NUMBER OF ADULTS 18+:___________ NUMBER OF CHILDREN UNDER 18___________
13. County I.D. or G.A. Number if applicable:
Office Use only
Staff verification, Name and title________________________________________________Comments___________________________________________
DENIED APPROVED: Amount $ ______________Amount due from participant $________________Date due______________
Community Pass Account #_______________________ Applied to acct. Date_______________________________by:
10. Contact info:
Father/ Legal Guardian, Self if over 18:
Mother/ legal guardian:
Name
Address
Preferred phone #
Email address
Employer
Employer address
14. PAID: check:
 Once a Month
2 times/ month
Every other week
Weekly
Other
15. List any unusual circumstances / information / unusual monthly expenses, comments regarding your application:
click to sign
signature
click to edit
SOUTH BRUNSWICK PARKS AND RECREATION - TUITION ASSISTANCE INSTRUCTIONS:
Permanent Residents of South Brunswick only may apply.
The application is for programs sponsored by South Brunswick Department of Recreation only.
o Other organizations have their own financial aid forms and policies. Please see their website or contact the
office of those organizations that maintain one.
No financial assistance is available for facility rentals, permits or the dog park.
Please contact the office at 732 329 4000, ext. 7671 with any questions.
1. Complete Tuition Assistance Application. Provide all information and documentation requested.
a. All information is considered confidential and will be reviewed by the Department director, only.
b. It is preferred that the application and documentation be received by the office for approval prior to the
registration. In this way we can credit your Community Pass account in advance.
2. Attach:
a. Copy of one month's worth of paystubs for income earners in family.
b. Copy of most recent Federal 1040 (1st two pages).
If your tax form shows self-employment income or business income, you must submit your entire
Federal 1040, including self-employment or business income schedules. You may be required to also
submit your business' balance sheet year to date.
3. Forward application and documentation to the Recreation Dept.:
a. Mail completed application and back up documentation to
Parks and Recreation, PO Box 190, Monmouth Junction, NJ 08852 Attn: Director.
b. Forms can be dropped off at our office:
Community Center, Woodlot Park, 124 New Rd., Monmouth Junction Weekdays, 8:30 AM 4:00 PM.
c. Forms can be scanned & emailed to recreation@sbtnj.net
d. Forms can be faxed to 732-821-2811
4. Deadline for submitting tuition assistance application and documentation (in order to hold your space in the
program.)
a. Those programs not listing a deadline are due within 5 business days of online registration
b. For Camp programs: (or programs where there are multiple sessions per season):
One session per child will be considered for financial assistance, per season only.
Application for assistance is the Tuesday after Memorial Day Weekend in May. Requests received after
that date may be denied.
5. Tuition assistance applications will not be processed or approved:
a. Until the documentation is received or if income cannot be verified.
b. If deadlines are not followed by the applicant.
c. If there are outstanding recreation fees due from your Community Pass acct.
d. If you do not reply to correspondence or emails immediately; your tuition assistance will not be approved until
we hear from you and you risk losing your space in the program
6. Applicants MAY BE REQUIRED TO PAY a PARTIAL FEE if application is approved,;
a. This is due within 2 weeks of approval (unless you make other arrangements) or by the payment deadline
indicated, whichever comes first; a space in the program will be held for you until this date.
b. No one may participate in a program without paying their portion of the fee.
c. If payment is a problem, or meeting any deadline date, it is up to you to contact the office.
7. Program Registration:
a. Register for the program online on Community Pass before the registration deadline.
b. If you do not have access to a computer, or need assistance registering, register in person at the Recreation
office in the Community Center during business hours, weekdays or call the office.
c. When registering, for payment, click 'no payment'. This will be updated after application review.
A due date / deadline for payment of your portion of the fee if any, will be given to you.
We reserve the right to withdraw your registration if there is a waiting list for the program and you do
not meet your financial obligation.
8. Participants approved for financial assistance who later are unable to participate in the activity (or do not show up to
participate): Call or email the office to be withdrawn from the program or future financial assistance may be denied.
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