Application for Scholorship

Application for Scholorship

applications received are on first come / first served basis with financial need
Before completing the scholarship application form, you MUST complete the following steps:
1. Complete the player application at www.ayso5.org
2. Complete the volunteer application at www.ayso5.org and the verified background check.
Apply early as grants are limited. You will be notified once your scholarship is approved.
Players Name *

First Name Last Name
Players Birth Date *

Month Day Year
Date
Players Grade *
Players Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Players Gender *

Male Female
How Did You Hear About the Scholorship Program?
Parent Information

First Name Last Name
Address (If Not Same as Players)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent Cell Phone *

Area Code Phone Number
Parent Email *
example@example.com
I have completed an online AYSO volunteer application *

Yes No
Financial Information
Is your child receiving / eligible for free or reduced school lunch? *

Yes No
Number of people living in the household: *
How much of a contribution will you be able to make towards registration fees? *
Whole dollars only, Do not include $ sign
Have you received an AYSO Region 5 Scholorship before? *

Yes No
I have answered the above questions to the best of my ability.

I have been honest about the family's situation.

I allow AYSO Region 5 to make additional inquiries on the legitimacy of this request.
Date

Month Day Year
Date
Signature *

Clear
Should be Empty:

Application for Scholorship

Financial Information