Fee Assistance Payment Agreement


Daycare Action Council (DHS/ Illinois Action for Children)

​Required for Registration

  • Deposit/Registration fees per program as applicable (i.e. $50 per section for camp and 50% for programs per child)
  • DHS Award Letter or Change of Provider Letter
     

Applying for Skokie Park District Fee Assistance

Please note: 

  • This is NOT the Fee Assistance Application; click here for application
  • Skokie Park District fee assistance never covers more than 50% of the cost of a camp/activity. Refer to the Fee Assistance Guidelines.

​Required for Registration

  • Activity/Program: 50% payment of activity/program fee.
  • Camp: $50 deposit per camp, per child. After June 1, 50% deposit per camp, per child.

​Required within 5 days

  • Fully completed Skokie Park District Fee Assistance Application and supporting paperwork OR payment in full.
     

Special Payment Plan (not the standard installment plan)

Required for Registration

  • Manager's Authorization/Signature and Date
  • Manager's Payment Schedule with amount(s) and date(s)
     

Other (please fill in the name of the organization below)

Required for Registration

  • Organization's Award Letter
  • If organization does not award 100% of fees payment of any amount not awarded will be due.

 


  • I understand that if I did not turn in paperwork today, I must turn in any and all required paperwork within five (5) business days or I must pay in full in order for child(ren) to remain enrolled in class/activity(s).
  • If class/activity(s) are being paid by an agency, such as Daycare Action Council, I understand that any amount unpaid by any agency is fully my responsibility. I also understand that Daycare Action Council does not pay for days that my child does not attend and that I am responsible for paying those days.
  • If I apply for fee assistance, I understand that all fee assistance is legally recoverable if awarded on the basis of false information supplied by the applicant. 
  • I understand that fee assistance is never more than 50% of the cost of class/activity and that I am responsible for any amount not covered by fee assistance. 

 

 

CLICK THE SUBMIT BUTTON BELOW TO COMPLETE YOUR REQUEST.

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