Recipient Information:
Enter the name of the person who will be receiving the pass, lessons or rentals from UVSSF.
Name (First and Last):
*
Age:
*
Contact Information:
Please check the appropriate box:
*
I am the parent or guardian of the applicant.
I am an adult applicant (18 years or older).
Your Name (First and Last):
*
Occupation and Employer:
*
Mailing Address:
*
Email Address:
*
Home or cell phone:
*
Other Parent/Guardian Information (If there is a second parent/guardian, please enter name, occupation and employer):
Other Parent/Guardian Email:
Program Questions
Check all that apply to your financial assistance request
Ski & Snowboard Camp
Season Pass (enter type of pass below)
Ski Package Rental
Snowboard Package Rental
Camp or Clinic (enter which camp or clinic below)
After-School Program (enter school name below)
Whaleback Mountain Club/Core Team (Check here to have your application sent to WMC Financial Aid Committee)
Summer Camp
Season Pass Type (skip if you do not need a pass):
Youth (6-12)
Teen (13-19)
Adult (20-64)
Senior (65+)
Training Pass
Applicant qualifies for one or more of the following special pass categories (skip if you do not need a pass):
3rd Grader
Military
Enfield Resident
After-School Program Information - school name (skip if this does not apply):
Summer Camp Weeks -Select All That Apply (skip if this does not apply):
Week 1
Week 2
Week 3
Week 4
Week 5
Camp or Clinic - state which Whaleback camp or clinic (skip if this does not apply):
Are you applying for Whaleback Mountain Club/Core Team financial aid as well?
Yes
No
Whaleback Mountain Club/Core Team
Whaleback Mountain Club/Core Team Program (skip if application is not being forwarded to WMC Financial Aid Committee)
Mini-Core
Mini-Core Plus
Mini-Core Snowboard
Devo
Devo Comp Team
Core Team Freestyle
Core Team Snowboard
Core Team All Mountain Club
Financial/Household Information
Total Number of People Living in Household (regardless of marital or living status):
*
1
2
3
4
5
6+
Number of Dependents in Household (Indicate total number of dependents, regardless of marital or living status.)
*
1
2
3
4
5
6+
Annual Household Income (Please indicate the combined income of both parent/guardians, regardless of marital or living status.)
*
Do you (your family) qualify for free/reduced lunch, food stamps, or a similar program?
*
Yes
No
Please describe any extenuating circumstances that are currently causing a financial burden.
*
How would an award positively impact the recipient's life?
*
Amount (if any) you are able to contribute to total cost:
*
Upload last signed 1040 here:
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