Application Child's Name* Date of Birth* Gender*MaleFemale Grade of Child* Child’s Address* Child's City/Town* Child Zip Code* Activity Business Name* Activity Business Address* Activity Business Contact Name* Activity Business Contact's Phone* Activity Business Contact Email* Activity Description* Activity Length* Activity Cost* Activity Monthly Cost Activity Start Date* How funding from ConfiKids would help: * List other funding sources: Applicant Name and Relation to Child* Applicant Phone* Applicant Email* Message* Emailed the Lunch Letter: *Yes, I have emailed the letter to coordinator@confikids.orgNo, not yet. I understand my application will NOT be reviewed until Confikids receives that letter. If I do not email it to them within 10 days, this application will be declined and I will need to apply again when I have the letter. reCAPTCHASubmitReset