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Hope on the Prairies Foundation Inc. offers sponsorship support to individuals and families facing financial challenges. If you’re in need of assistance, we invite you to submit an application for consideration.

Please complete the form below with as much detail as possible. Note: Funding is not guaranteed and may only cover a portion of the total cost requested.

NOW ACCEPTING APPLICATIONS

Personal Information

Full Name:

Date of Birth:

Year

Month

Day

Address:

Email:

Phone

Parent/Guardian Information (if applicable)

Parent/Guardian Name:

Parent/Guardian Address:

Relationship to Child:

Parent/Guardian Phone:

Parent/Guardian Email:

Household Information

Number of Adults in the Home:

Number of Children in the Home:

Do you have treaty status?

Yes

Do you have coverage under a benefit program?

Yes

Annual gross income for all income earners in the household:

Please detail your situation, including what you are requiring assistance for, the cost associated, and the length of time required:

By submitting this application, I confirm that the information provided is accurate. Please note, funding is not guaranteed and may only cover a portion of the cost requested.

Signature

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Date of Application:

Year

Month

Day