Clone of Del Norte - Training/Lessons Contact

Contact Information
Primary Adult*
Email*
example@example.com
Date or Birth

MonthDayYear
Date
Phone Number*
Format: (000) 000-0000.
YesNot
Secondary Adult*
Date or Birth

MonthDayYear
Date
Number of dependents (children living with you that are 26 years old or less) *
Child Dependent 1*
Date or Birth

MonthDayYear
Date
Child Dependent 2*
Date or Birth

MonthDayYear
Date
Child Dependent 3*
Date or Birth

MonthDayYear
Date
Child Dependent 4*
Date or Birth

MonthDayYear
Date
Please list the first and last names + date of birth for each child.
i.e. Sam Smith, 11/30/2017
Please explaining your current financial situation and reason for requesting aid.

0/800

Financial Information

For financial scholarship list all income you receive including housing (room and board). Assistance will be granted primarily on the basis of financial needs. Applications will be asked to pay a portion of membership dues/program fees. If not amount is earned, enter 0.
Employment Amount*
SSI/SSD*
Other Income*
Total Income
Yes, will share documentsNo, have additional questions

Scholarship Type

Please note that approval of scholarship for a program(s) does not guarantee you a enrollment spot. Scholarships will be granted to the extent that they are available.
Service ScholarshipFinancial Scholarship
YesNo

Acknowledgement of Application
I certify that the information provided in this application is accurate and complete to the best of my knowledge. I understand that Del Norte Club may request additional documentation to verify the information submitted.

For applicants requesting a Financial Scholarship, the following documentation is required: a copy of the most recent federal tax return and the two most recent pay stubs. Financial Scholarship applications cannot be processed until these documents have been received.

I understand that scholarship eligibility may be reviewed periodically. If requested documentation is not provided or program payments are not kept current, scholarship assistance may be adjusted or discontinued.

Participants receiving scholarship assistance are expected to follow the rules and policies of Del Norte Club.

I understand that scholarship applications may take up to two weeks to review and process.
Your signature indicates that you have read and understand the information stated.*
Please verify that you are human*
Should be Empty:

Contact Information