AR/HPOT - Dave Ball Memorial Scholarship Application 2025

Our organization is primarily funded through our wonderful donors. TRI's program fees are less than a quarter of the actual cost of providing the service. This subsidized rate is an effort to make the benefits of equine assisted services as affordable as possible to everyone. Participants are expected to contribute to their own program fees and/or to seek third party funding. Participants who still cannot cover the full cost of programming may apply for a Leg Up Scholarship from TRI to assist them.

Decisions are based primarily on financial need with a strong preference toward participants whose circumstances will hinder their participation without financial assistance. Other factors considered during application review are the anticipated benefits to the participant, the commitment to attending registered programs, and available scholarship funds.

Participant Name*

Is this participant a:*

Participant Address*

Participant City*

State*

Zip*

Parent/Guardian (if applicable)

Phone Number*

Email*

example@example.com

Which Session are you applying for?*

Service Type?*

Total cost of TRI services for the Session and Service Type selected*

Total scholarship amount requested*

Have you previously applied for a scholarship with TRI?*

While the Therapeutic Riding Institute values its ability to continue to provide scholarships to eligible participants, we also encourage all applicants to seek other sources of funding outside of our organization. You can find a list of support funding resources here: https://www.triohio.org/payment-assistance .

Please Indicate that you have reviewed the above list of funding resources here

Have you applied for Third Party Assistance for these services?

If Yes, what organization and how much were you awarded?

If No or if you were denied assistance by an organization please provide details

Please provide accurate financial details. The approval and amount of scholarship awards is contingent on your financial details. Applications with incomplete or inaccurate financial details will not be accepted. TRI reserves the right to request proof of income.

All financial details should be stated for the household in which the participant resides and/or the individuals that claim the participant as a dependent. Do not include information for individuals living outside the participant's household unless those individuals claim the participant as a dependent on their tax return.

1. Total Monthly Income After Taxes - Income includes the take-home pay of all earners in the household, child support, alimony, Federal and State assistance etc. Do not report gross wages before taxes.*

2. Total Monthly Expenses - Expenses include necessities such as rent, mortgage, utilities, food, vehicle expenses, property taxes, health insurance premiums not withheld by employers, medical care, etc. Do not include recreational or non-essential expenses*

3. Monthly Net Income - Line 1 minus Line 2*

4. Adjusted Gross Income (AGI) for most recent tax year*

Total number of individuals supported by the income above, including all earners and dependents*

Total number of residences included in the expenses reported above (i.e. if the participant is a dependent living in a separate home from the individuals that claim them, are the expenses for one or two homes reported?)*

What other financial details and/or explanations would you like to provide that support this request for scholarship assistance?

What benefits does the participant see from engaging in services at TRI?*

I verify that all information provided is correct, complete, and accurate. If my situation changes, I agree to notify TRI within 30 days. If I submit false or inaccurate information or fail to notify TRI of changes within 30 days, I may be terminated from the scholarship program.

I understand that scholarships are awarded by session to assist in the cost of fees for eligible TRI programs. I understand that scholarship monies awarded will not be refunded, credited toward a participant's financial responsibility, or carried over into the next session.

Signature of Applicant or Guardian*

Date*

Date