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4. 2026 Fee Assistance Application- Swim Lessons

   Thank you for your interest in the Fee Assistance Program at the Anoka Aquatic Center. Fee Assistance is applicable for the Anoka Aquatic Center Swim Lesson Program (group lessons) and is only valid for the current season. The City of Anoka does not grant fee assistance for Anoka Aquatic Center Season Pass purchases. It is the view of the Anoka City Council and City of Anoka Park and Recreation Advisory  Board, that no child be denied the opportunity to learn how to swim. Fee Assistance is not available for open swim, private lessons, Guard Start, Lifeguard Training courses, or AACES.

   Please be sure to complete the entire application. Awards vary depending on household size and income. Report of income is based on the honor system. Income verification is not required. The fee charged will be based on the following Income Guidelines (2026) based on Annual Income. All information you provide is considered private data and will be held in confidence.

   Fee Assistance: 

   50% Off – Low Income Assistance
   35% Off – Moderately Low Assistance

6. Size of Household	Low	Moderatly Low
   2	Under $40,000	Under $51,000
   3	Under $51,000	Under $62,000
   4	Under $62,000	Under $73,000
   5	Under $73,000	Under $83,000
   6	Under $83,000	Under $94,000
   7	Under $94,000	Under $105,000
   8	Under $105,000	Under $115,000

8. Family Information
10. First Name*
11. Last Name*
13. Address*
15. City*
16. State*
17. Zip Code*
19. Phone Number*
20. Email Address*
22. Household Size *

    Include Parents/Gardians & Child(ren)

24. Please list the names, ages, and birthdates of all family members living in the household.*
26. Income Information: List the Wage Earner(s) below:*
28. Income Reporting:
30. 1. Employment- Income before deductions*
32. 2. Social Security Pensions/Retirement:*
34. 3. Strike Benefits:*
36. 4. Welfare, Child Support, Alimony:*
38. 5. Unemployment, Workman's Compensation:*
40. Total Monthly Income:*
42. Total Annual Income (above x 12)*
44. Eligibility Requirements:
    1. Awards range from a discount of 35 – 50% based on income and household size
    2. The policy limits participation to one class per session per individual.
    3. The maximum award will be applied to the first session registered per child.
    4. Parent/child classes are to be treated as one class and assigned to the child.
    5. Specialty classes/programs, and private lessons are not eligible for fee assistance.
45. Confidentiality:

    Information you provide will be treated confidentially and will be used only for eligibility determinations and verifications of area.

47. I certify that all the above information is true, correct, and that all income is reported.
49. Electronic Signature Agreement*

    1. I agree

    By clicking "I agree" you certify that all in the document is true.

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51. 1. Receive an email copy of this form.
52. Email address

    This field is not part of the form submission.

53. Submit

* indicates a required field