Assisted Goals Foundation Financial Assistance Application

Documents required to receive scholarshipThis page is strictly informational please click next to start Application

Complete Application

USA Hockey Number

Photocopy of Child's Birth Certificate (Verification only)

Photocopy of Parents/Guardian Taxes (Verification only)

Player Information* This field is required.Name

First Name

Middle Name

Last Name

Birthyear

Player Information* This field is required.Gender

Parent/Guardian Information* This field is required.Name

First Name

Last Name

Parent/Guardian Information* This field is required.Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Parent/Guardian InformationPhone Number

Please enter a valid phone number.

Parent/Guardian Information* This field is required.Email

example@example.com

Parent/Guardian Household Income* This field is required.

$25,000 or less

$25,001 - $35,000

$35,001 - $45,000

$45,001 - $55,000

$55,001 - $65,000

$65,001 - $75,000

$75,001 - $85,000

$85,001 - $95,000

$95,001 - $105,000

$105,000+

Currently Enrolled in USA Hockey* This field is required.

YESNO

USA Hockey Number* This field is required.

Number of Years Enrolled in USA Hockey* This field is required.

0-1

1-2

2-3

3-4

4-5

5-6

Number of Children Enrolled in USA Hockey* This field is required.

Level of Play* This field is required.

Mites

Squirts

Pee Wee

Bantam

Minor Midget

Major Midget

Local Middle School

Local High School

Not Enrolled

Currently Playing on a Travel Team* This field is required.

YESNO

Which NHL market are you nearest to?* This field is required.

Briefly describe in 1,000 words or less why you could use a scholarship from ASG you can upload your file below Please upload in .pdf or .docx format

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Assisted Goals Foundation Financial Assistance Application