Financial Assistance (Scholarship) Application

Financial Assistance (Scholarship) Application

Financial Assistance (Scholarship) Application
Parent/Guardian 1:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Work Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com

Parent/Guardian 2

First NameLast Name
Address if different than Parent/Guardian 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Assistance is being requested for the following child/Children:

Player:   First Name   Last Name   Division:

Player:   First Name   Last Name   Division:

Player:   First Name   Last Name   Division:

Player:   First Name   Last Name   Division:
Did your child/childnre participate in off-season hockey programs?
If yes, what programs?

Married Filing JointlyMarried Filing SeparatelySingleHead of HouseholdWidow
Size of Household:*
Number of Adults living in household:*
Number of children living in household:*
Total Household income for the year (from all sources)*
Total Household expenses for the year*
YesNo

Please explain why financial assistance is needed. Provide as much information as possible.*

Authorization:

I herby certify that the information submitted on this form is true and correct, and I understand the Saints may verify the information on this application or ask for additional information. Providing false information will result in denial or financial assistance.
Signature Parent/Guardian 1*
Signature Parent/Guardian 2

Please attach most recent IRS federal income tax return 1040 or 1040A, including supporting tax schedules (if applicable). First 2 pages only please, black out any social security number. All information will be kept confidential and only viewed by the scholarship committee of the Saints Board of Directors.

Cancelof
Should be Empty: