Richmond, CA · Contra Costa County
Low-Income Resident Fee Adjustment Application
Richmond residents apply using this Spanish-language form for a fee adjustment for eligible Elevate summer camp or after-school programs.
What this form is
This application asks Richmond residents to show residency, their relationship to the child enrolling, and household income to request a fee adjustment. The form says eligibility conditions must be met at enrollment and applies only to Elevate summer camp and after-school program registration fees. Applicants provide household information, certify their income, and attach documents verifying residency, relationship, and income.
Who needs it
A Richmond resident who is a child’s parent or legal guardian and seeks a fee adjustment for an eligible Elevate program should complete this application.
How to submit it
The form says to provide the completed application and required verification documents at registration. Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the applicant certifies the information under penalty of perjury and signs and dates the application.
How to submit this form
- 1
Download The Application
Download the Spanish-language Low-Income Resident Fee Adjustment Application.
- 2
Complete The Application
Print clearly and provide applicant, household, residency, relationship, and income information.
- 3
Gather Required Documents
Attach documents verifying residency, relationship to the child, and household income.
- 4
Provide It At Registration
Submit the completed application and required verification documents at registration.
Frequently asked questions
- Do I need a notary for the Low-Income Resident Fee Adjustment Application?
- No. The applicant signs and dates the form and certifies the information under penalty of perjury; no notary block is included.
- How do I submit the Low-Income Resident Fee Adjustment Application?
- Provide the completed application and required verification documents at registration. The form names the Community Services Department but gives no submission address or online method.
- What documents must I attach?
- Attach documents verifying Richmond residency, your relationship to the child, and household income. Examples listed include a utility bill, birth certificate or court document, and income records.
- Which programs qualify for a fee adjustment?
- The application says adjustments apply only to registration fees for Elevate summer camp and Elevate after-school programs. Additional course fees for field trips must be paid in full.
Need something notarized?
This Low-Income Resident Fee Adjustment Application doesn’t need a notary — but if you have another Richmond form that does, a commissioned online notary can help.