Required fields are marked with asterisks (*)

Fee Subsidy Application for Licensed Child Care or Recreation Camp Program

To apply for fee subsidy please complete and submit this form.

Once submitted you will receive a copy sent to you as a PDF attachment for your records. A copy will also be received in our office.

Applicants are required to have a confirmed space in licensed child care or a recreation camp program in to apply for fee subsidy and must be a resident of Leeds and Grenville to be eligible.

Applicants will be contacted by telephone to review the application and set up an appointment with a case manager.

The information in the application is used to determine an applicant's financial eligibility for fee subsidy. Application does not guarantee eligibility.

A staff person will contact you within 5 working days to arrange an appointment.

If you have any questions or require assistance while completing this form, a Program Support would be happy to assist you. Contact 613-342-3840, extension 2351.

Start Date:

Section 1: Applicant Information

Applicant 1:

Last Name:

First Name:

Previous Name (if applicable):

Date of Birth:

Email Address

Street Address

Apartment/Unit/Box No.:

City

Postal Code

Municipality

Contact Phone Number

Best time to contact you by telephone, Monday to Friday, 8:00 a.m. to 4:00 p.m.

Applicant 2:

Last Name

First Name

Previous Name (if applicable)

Date of Birth (dd/mm/yyyy)

Section 2: Application History

If yes, what is the name of the child care program site or recreational camp program – list all: