Scholarship Application

Application for Scholarship

Applications are reviewed and approved on a case by case basis. Financial needs are taken into consideration.
Before completing the scholarship application form, you MUST complete the following steps:

Complete the player application at www.ayso5.org
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.
Player's Name (First & Last Name)*
Player's Birthday*

MonthDayYear
Date
Player's Grade During the Season*
Player's Gender*

MaleFemale
Player's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about the Scholarship Program?
Parent Name*

First NameLast Name
Parent Email*
example@example.com
Parent Phone Number*
Please enter a valid phone number.
I have completed an online AYSO volunteer application*

YesNo
Financial Information
Have you been granted a scholarship from Region 5 in the past 3 years?*

YesNo
Is your player receiving/eligible for free or reduced school lunch?*

YesNo
Number of people living in your household?*
How much of a contribution will you be able to make towards the registration fees?*
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.
Today's Date*

MonthDayYear
Date
Parent Signature*

Clear
Should be Empty:

Application for Scholarship