KidsPlay Scholarship Application

KIDSPLAY FUNDING APPLICATION

For youth enrichment and extracurricular activities, Grades 3-12.
Student Name*

First NameLast Name
Name of Person completing this form*

First NameLast Name
What is your relationship to the student?*

ParentLegal GuardianOther RelativeTeacherOther
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender*
KidsPlay™ currently supports participants in 3rd-12th grade, who demonstrate financial need by submitting a KidsPlay™ application and supporting documentation. Students must currently either reside within or attend school within the boundaries of the Orange Unified School District.
Student Grade (3rd-12th ONLY)*
Student School*
Student Date of Birth*
Email*
example@example.com
Email (please type email again to verify)*
example@example.com
Parent Cell Phone Number*

Area CodePhone Number
Name of League/Class*
Start Date*

MonthDayYear
Date
Location of class, if art or music*
if not applicable, please enter NA
Please select:*

This is a recreational sports leagueThis is a club level sports leagueThis is a music classThis is an art classThis is a City of Orange recreation classOther
Please provide an email address for the coach/instructor so we can verify registration and fees:*
example@example.com
Please note that KidsPlay does not fund late registration fees, transaction fees, or membership fees. The maximum annual amount that KidsPlay will fund per child is $250.00
How much is the total registration fee for this league/class?*
Mailing Address of LEAGUE OR ORGANIZATION for check*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about KidsPlay™?*
Any other comments?
In order to verify need, please submit one or more of the following with this application (by using the upload buttons below or by mail)

Copy of child's Medi-Cal statement or ID cardCopy of CalFresh card (formerly SNAP)Verification of enrollment in an OUSD Grip program (can be coordinator confirmed)Referral from school administrator such a principal or counselor. (Please provide name and phone number of person referring)
Name of person referring you to KidsPlay™
Upload Document One

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Upload Document Two

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KIDSPLAY FUNDING APPLICATION