Financial Aid Self Attestation

Purpose

Windfall Equine Therapy Center (WETC) is committed to making equine-assisted services accessible to individuals and families experiencing financial hardship. To ensure that financial assistance is distributed fairly and consistently, WETC offers a sliding scale fee structure based on household income and family size.

Financial assitance is available to cover up to 100% of program costs.

Eligibility

Sliding scale discounts are determined using the current Federal Poverty Guidelines (FPG) published annually by the U.S. Department of Health and Human Services. Eligibility is based on total household income and the number of individuals living in the household.

Financial assistance is available only for approved WETC programs and is subject to available funding.

Applicant Information

Participant Name

Parent/Guardian (if participant under 18)

Street Address

City

State

Zip Code

Phone

Self-Attestation Statement

I am requesting financial assistance through Windfall Equine Therapy Center (WETC). By signing below, I certify and acknowledge the following

I certify that (must check all boxes):

The information I have provided on my Financial Assistance Application and all supporting documentation is complete, true, and accurate to the best of my knowledge.

The income documentation I have submitted accurately reflects my current household financial situation.

I understand that Windfall Equine Therapy Center may request additional documentation if needed to determine my eligibility for financial assistance.

Acknowledgement

I understand and acknowledge that (must check all boxes):

Financial assistance is provided based on available funding and program eligibility requirements and is not guaranteed.

Intentionally providing false, misleading, or incomplete information may result in: Denial of my application; Reduction or termination of financial assistance; Repayment of financial assistance received if awarded based on fraudulent information; and/or Ineligibility for future financial assistance programs offered by WETC.

Windfall Equine Therapy Center reserves the right to verify the information provided when appropriate.

Change in Financial Circumstances

I agree to the following (must check all boxes)

I agree to notify Windfall Equine Therapy Center within 30 days if there is a significant change in my household's financial circumstances during the period my financial assistance is active, including but not limited to: Employment or job loss, Significant increase or decrease in household income, Change in household size, Receipt or loss of government assistance, Other material financial changes that may affect my eligibility

I understand that changes in financial circumstances may result in my financial assistance being reviewed and adjusted.

Documentation

Documentation Uploaded:

Upload financial aid determination documents.

Applicant Certification

I agree that by entering my name below I certify that I have read, understand, and agree to the statements contained in this Financial Assistance Self-Attestation Form.