River CIty Promise Program

River City Promise Program - Financial Assistance Application

Please complete the following application and submit all necessary forms to apply for financial assistance.
Contact Information
Name of person completing application*

First NameLast Name
Relationship to Player*
E-mail Address*
Phone Number

Area CodePhone Number
Player Information 1
Players Name*

First NameLast Name
Players Date of Birth*

MonthDayYear
Gender

MaleFemale
River City FC Team
Player Information 2
Players Name*

First NameLast Name
Players Date of Birth*

MonthDayYear
Gender

MaleFemale
River City FC Team
Financial Information

Must be completed and supporting financial documents must be submitted in order to be considered for financial aid awards.
Total Gross Annual Household Income, from all sourcse derived*
Parent Information
Parent 1 Name

First NameMiddle NameLast NameSuffix
Parent 1 Phone Number

Area CodePhone Number
Parent 1 Occupation*
Parent 1 Employer
Parent 1 Annual Salary*
Parent 1 Other Income
Including child support, alimony, governmental assistance, etc
Parent 2 Full Name*

First NameMiddle NameLast NameSuffix
Parent 2 Phone Number*

Area CodePhone Number
Parent 2 Occupation*
Parent 2 Employer
Parent 2 Annual Salary*
US Dollars
Parent 2 Additional Income
Including child support, alimony, governmental assistance, etc
With Whom Does The Player Live?*

Both mother & fatherMotherFatherOther
Parents are*

MarriedDivorcedSeperatedOther
Please list the number and ages of any other dependent children in the home:
Do you rent or own your home?*

RentOwnOther
Please share your story and any additional information that will help in determining your need for financial assistance:
Upload of Required Financial Documents

Please note that this information is verified for award purposes and then destroyed. ***Forsecurity purposes, please obscure social security numbers***
Before continuing, the following information is REQUIRED and must be
submitted with your application for EACH parent/guardian listed above:

(for security purposes, please obscure social security numbers)

Copy of most recent pay stub AND
Copy of most recent year's signed Federal Income Tax Return (Form
1040 or 1040EZ)
Copy of most recent pay stub

Browse Files
If unable to upload please email documents to: jason@rivercityfc.com Cancelof
Copy of most recent year's Federal Income Tax Return

Browse Files
If unable to upload please email documents to: jason@rivercityfc.com Cancelof
If you are unable to include a copy of your most recent pay stub for each parent/guardian,please provide additional explanation. Please note, this information must be supplied inorder to receive financial assistance.
If you are unable to include a copy of your most recent Federal income tax return, pleaseprovide additional explanation. Please note, this information must be supplied in order toreceive financial assistance.
Certify and Submit
Certification

I, hereby, certify that the information provided in this application is accurate and complete to thebest of my knowledge. I understand that any misrepresentation of the information herein may resultin the denial of financial assistance.
Should be Empty:

River City Promise Program - Financial Assistance Application

Contact Information

Player Information 1

Player Information 2

Financial Information

Parent Information

Upload of Required Financial Documents

Certify and Submit