Scholarship Application

Scholarship Application

City of Fridley Parks & Recreation
Who Qualifies?
Scholarship funds are available to FRIDLEY residents only. Participants must remain full-time residents of Fridley during the activities they have received scholarships for. Proof of residency or income need may be requested at the time of application. Households must have a scholarship application digitally signed and dated for each calendar year of participation in the program.

Applications must be renewed annually.

What Qualifies?
Individuals that qualify for the scholarship program will receive a subsidy for the remainder of the calendar year, applicable towards eligible recreation programs and classes.

Summer ROCKS and Adult Sports Leagues are not eligible.

Who Can Fill Out This Application?
Parent, guardians, and adults over the age of 18 can complete this application.

If you are completing this application for children, you must be their primary caregiver.

Scholarship Guidelines:
In event you can no longer participate in a registered program, we ask that you call the Recreation office at 763-572-3570 to cancel.

Staff reserves the right to cancel a program registration if an individual enrolled through scholarship does not attend classes on a regular basis without communication to recreation.
Name of Adult Completing the Application*

First NameLast Name
Address*

Street Address

Apartment or Condo Number

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
How many children would you like to apply for scholarships for?
Please call or email recreation if you have more than 4 children and would like to apply for scholarship.
Child 1 - Name

First NameLast Name
Child 1 - Date of Birth

MonthDayYear
Child 1 - School Name
If applicable
Child 1 - School Grade
If applicable
Child 1 - Teacher Last Name
If applicable
Child 2 - Name

First NameLast Name
Child 2 - Date of Birth

MonthDayYear
Child 2 - School Name
If applicable
Child 2 - School Grade
If applicable
Child 2 - Teacher Last Name
If applicable
Child 3 - Name

First NameLast Name
Child 3 - Date of Birth

MonthDayYear
Child 3 - School Name
If applicable
Child 3 - School Grade
Child 3 - Teacher Last Name
If applicable
Child 4 - Name

First NameLast Name
Child 4 - Date of Birth

MonthDayYear
Child 4 - School Name
If applicable
Child 4 - School Grade
If applicable
Child 4 - Teacher Last Name
If applicable
How many Adults would you like to apply for scholarships for?
Adult 1 - Leave blank if name is the same as individual completing the form.

First NameLast Name
Adult 1 - Date of Birth

MonthDayYear
Adult 2 - Additional Name

First NameLast Name
Adult 2 - Date of Birth

MonthDayYear
Adult 2 - Phone Number
Please enter a valid phone number.
Adult 2 - Email
example@example.com
By checking the box, I certify that I or my household will benefit from the City of Fridley scholarship program and that it will allow for enrollment in classes, activities, or programs that may otherwise present a financial barrier to participation.*

Agree/Certify
By providing my signature, I declare that the scholarship application information provided is true and complete.

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In accordance with the MN Government Data Practices Act, the Recreation staff of Fridley hereby informs you that the personal information we are requesting of you and/or your children on this form is considered private. Private data is available to you and to City staff who need to have this information to administer the program – but not to the public.
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