Program Assistance (Application)

Apply for Program Assistance to participate in our equine-assisted programs!

We are excited to introduce the Program Assistance Program. This new program will take the place of the Scholarship Program and will enable us to award more assistance to more families!

Special Note:  If you are affiliated with Phelps County, Nebraska, thanks to the Women’s Giving Group is covering a substantial amount of your child’s program cost. No Program Assistance Application is needed. 

  • All programs are subsidized by business sponsors, grants, fundraisers and individual donations allowing everyone, regardless of income, to participate.
  • Program fees are based on the number of hours and days each program offers.
  • We understand that not all families can participate without receiving additional assistance.
  • Please complete the application – in its entirety – and include the supporting documents.
  • Please use the space to help us understand your financial situation.
  • Our goal is to accommodate every family as best we can.
  • Families will be contacted by email unless otherwise requested.
  • For a limited time only, thanks to a generous grant from the Women’s Giving Group, youth living in or attending school in Phelps County may participate at a reduced fee. – No program assistance application needed.

Applicant Information

Name (Parent/Guardian)







Mailing Address















All Persons (All adults and children) Living in this Household
Adult or Child
First Name
Last Name
Date of Birth
Claimed on 1040?
 
I am applying for (name/ages of children/youth)

I am currently receiving the following assistance:

Financial Information

To qualify for program assistance for Level 1 or Level 2 program assistance, please attach at least one of the following documents. Black out all Social Security numbers.
- Recently filed Federal Taxes (1040 Federal Tax Form (3) for ALL income in household)
- Two recent pay stubs (Per working adult in household)
- Government Assistance (Showing most recent 30 days of income)

Drop files here or

Max. file size: 50 MB, Max. files: 3.

    Yearly Renewal

    I am requesting program assistance from LyonHeart Equine Assisted Learning due to my personal circumstances and verify that all information provided is correct, complete and accurate. If I submit false or inaccurate information, I may be terminated from receiving program assistance.
    Date