The personal information requested on this form is being collected under the authority of Alberta's Freedom of Information and Protection of Privacy Act, Section 33c and is protected under the Act. It will be used for the administration of the City of Lethbridge’s Recreation and Culture Fee Assistance Program. If you have any questions about the collection of this information contact 403-320-4716.

The City of Lethbridge reserves the right to refuse access to these funds to anyone who provides false information. In the event that any false information is discovered after an application has been approved, it will result in no further applications being accepted.

Main Household Contact

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
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{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

Funding Requests

First Name *
Last Name
Relation to Applicant *
Age *
Organisation and Class Name *
Amount Requested *

Item {binding ItemNumber}

{ binding firstError.message }
{ binding firstError.message }

If different from Main Household Contact

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to Main Household Contact

{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

Program Eligibility

Please upload the following documents to show that you meet the requirements for this program.

If you are having difficulty uploading your documents, you may submit the application without them, then email feeassistance@lethbridge.ca for help. However, uploading everything now will help us process your application more quickly.

{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}
{ binding firstError.message }
{ binding firstError.message }

Upload one of the following:

  • Bank or Credit Card Statement
  • Government Issued Letter or Notice
  • Current bill from utility provider such as home phone, gas, cable, energy provider
{ binding firstError.message }

Upload one of the following:

  • a current Medical Service Card if you are on AISH
  • a letter from a housing program such as Lethbridge Housing Authority if you are a client
  • a Direct Deposit Statement if you are on Income Support or EI
  • a copy of a Refugee Protection Claimant document if you are a refugee
  • a recent pay stub
  • a Tax Notice of Assessment
Besides financial, what other obstacles/barriers do you face when participating in community activities? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

Internal Use Only

{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

The personal information requested on this form is being collected under the authority of Alberta's Freedom of Information and Protection of Privacy Act, Section 33c and is protected under the Act. It will be used for the administration of the City of Lethbridge’s Recreation and Culture Fee Assistance Program. If you have any questions about the collection of this information contact 403-320-4716.

The City of Lethbridge reserves the right to refuse access to these funds to anyone who provides false information. In the event that any false information is discovered after an application has been approved, it will result in no further applications being accepted.

Main Household Contact

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Home/Cell Phone # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Alternate Phone # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Number of People in Household {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

Funding Requests

First Name
Last Name
Relation to Applicant
Age
Organisation and Class Name
Amount Requested

Item {binding ItemNumber}

First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Relation to Applicant {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Age {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Organisation and Class Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Amount Requested {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

Program Eligibility

Please upload the following documents to show that you meet the requirements for this program.

If you are having difficulty uploading your documents, you may submit the application without them, then email feeassistance@lethbridge.ca for help. However, uploading everything now will help us process your application more quickly.

Upload Documents {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{{ Cognito.resources['fileupload-dropzone-message'] }}
{binding Name, mode=oneTime}
{binding Description}
{ binding firstError.message }
Proof of Lethbridge Residency {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Upload one of the following:

  • Bank or Credit Card Statement
  • Government Issued Letter or Notice
  • Current bill from utility provider such as home phone, gas, cable, energy provider
Proof of Income Status {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Upload one of the following:

  • a current Medical Service Card if you are on AISH
  • a letter from a housing program such as Lethbridge Housing Authority if you are a client
  • a Direct Deposit Statement if you are on Income Support or EI
  • a copy of a Refugee Protection Claimant document if you are a refugee
  • a recent pay stub
  • a Tax Notice of Assessment
Besides financial, what other obstacles/barriers do you face when participating in community activities? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

Internal Use Only

Photo ID checked {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Proof of Address checked {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Proof of Qualification Provided {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Notes {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Outcome {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Reason (If Declined) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Organisation Notified {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Finance Notified {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
City Staff Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date Processed {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }