Michael Gerkin Form

USA-WWF Michael Gerken

Equipment Grant Application
Eligibility Requirements
- Juniors and Seniors collegiate status for grants

- Shows overall commitment to the sport through their Collegiate Ski Association and continued participation after their sophomore season
Read and follow the instructions carefully prior to submitting your application.
Read and Understand the instructions.*

Yes, I have
If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.
I. Personal Data:
Full Name*

First NameMiddle NameLast NameSuffix
Birthdate:*

MonthDayYear
Home Phone:*

Area CodePhone Number
Mobile Phone:*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender:

MaleFemale
Are you a US citizen?

YesNo
Are you a USA Water Ski Member?

YesNo
Number of Years
Sports Discipline
Membership Number
Member of USA-WWF

YesNo
Number of Years
Have you recently received a grant from USA-WWF?
If yes, please list
If yes, list years received.
II. College Information:
College Attended
College Team or Club Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business phone number

Area CodePhone Number
Student ID #
Status at the time of application:

Incoming JuniorIncoming SeniorSenior
Year of Expected Graduation
Do you plan to earn a Bachelor's Degree?

YesNo
Expected Degree Completion Date
List of Universities, Colleges, and High Schools previously attended. (Begin with most recent)
Please include years attended.
III. References
List only two references not related to you -- one academic (college professor/instructor/academic advisor), one other (team coach). Give each an attached Reference Form to be completed. It is the applicant’s responsibility to ensure that these Reference Forms are included and received by USA-WWF.
Reference #1

First NameLast Name
Phone Number

Area CodePhone Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Reference Letter #1

Upload a File

Cancelof
Reference #2

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Reference Letter #2

Upload a File

Cancelof
Honors Received (Also include Non-Ski honors)*
Why are you applying for this grant?*
Include any special personal or financial needs.
As a recipient, how do you feel you could contribute to water skiing?*
Include any special personal or financial needs.
IV. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:*
Date

MonthDayYearHourMinutesAM/PM Option
The USA Water Ski & Wake Sports Foundation is committed to equal opportunity in employment and education. The Foundation does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

Eligibility Requirements

I. Personal Data:

II. College Information:

III. References

IV. Applicant's E-Signature