Our Mission

To enable all young people, especially those who need us most, to reach their full potential as productive, caring, responsible citizens.

(812) 738-1696
[email protected]

Income Verification

The Boys & Girls Club offers program fees on a sliding scale based on the family’s income.

Please complete this form so that BGC staff can determine if you are eligible for a reduced rate!

Income Verification Information

"*" indicates required fields

Parent Name*
Note: Please enter the parent name associated with your household in our online membership system. This income verification will only apply to those youth included in your household.
Please include all youth in your household who attend/plan to attend our program and this scholarship request applies to.
Parent Email*
Please select the location(s) where your child(ren) are registered.
Enter the total ANNUAL wages for all those in your household
Enter the total ANNUAL tips/bonuses/commissions for all those in your household
Enter the total ANNUAL Social Security payments for all those in your household
Enter any other incomes (annually) for all those in your household
Please include all adults (including yourself) and dependents who live in your household
Please upload: Two most recent pay stubs for each adult living in the household and documentation for all other sources of income listed above. If verification of wages is not provided, all program fees will be processed at the highest level.
Drop files here or
Max. file size: 100 MB.