USTA MIDDLE STATES JR PLAYER COMP EXPENSE REIMBURSEMENT GRANT APPLICATION

USTA MIDDLE STATES JUNIOR PLAYER COMPETITION EXPENSE REIMBURSEMENT GRANT APPLICATION

This Grant is a partial reimbursement related to tournament expenses incurred during a tournament.

These expenses are: entry fee, player's airfare, and hotel

The receipts that are submitted should be related to the previous grant periods' expenses before the grant deadline.

It is a REQUIREMENT for consideration that your current Federal Tax Return is included in the documentation.

	Grant Period Dates	Grant Application Deadlines
Period 1	11/01 - 1/31	2/14
Period 2	2/01 - 4/30	5/14
Period 3	5/01 - 10/31	11/14

This Grant ranges from $250 - $1000 per grant period.

This Grant is a needs-based grant that is not a guarantee.

CONFIDENTIAL

(To be completed by parent/guardian of the player if under 18)

Junior Competition Expense Reimbursement Grant

This grant application is not a guarantee of reimbursement and is based on financial need.

Expenses incurred are associated with tournament participation (entry fee, player's airfare, and hotel)

Player's Name*
Date of Birth*
Age*
USTA Membership #*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian's Name*

First NameLast Name
Parent/Guardian's Email*
example@example.com
Home Phone

Area CodePhone Number
Parent/Guardian's Work Phone

Area CodePhone Number
Parent/Guardian's Address (only if different from Player)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Jr. Singles Ranking
National Rankings
Age Group
Sectional Rankings
Age Group
District Rankings
Age Group
Current Year Standings
National Ranking
Age Group
Sectional Ranking
Age Group
District Ranking
Age Group
USTA Middle States District (check one)*

AMDCPDDDEPDNJDPATD
Race / Ethnicity*

African-AmericanAsianLatino/HispanicNative AmericanCaucasianOther
Have you received financial assistance for tennis from any source, other than parents in the past year?*

YesNoOther
Name of Jr. Competition Tournaments for which expense reimbursement is requested (minimum of two events)*
Required Paperwork

PLEASE UPLOAD THE FOLLOWING REQUIRED PAPERWORK: All receipts associated with tournaments (entry fee, hotel, player's airfare). It is sufficient to submit the monthly credit card statement showing the airfare, hotel charges, entry fees.
Receipts must be submitted electronically/mailed/emailed. It is sufficient to submit the monthly credit card statement showing the airfare, hotel charges, entry fees
PLEASE UPLOAD YOUR RECEIPTS: All receipts associated with tournaments (entry fee, hotel, player's airfare). It is sufficient to submit the monthly credit card statement showing the airfare, hotel charges, entry fees.

Browse Files on Your Computer to Upload

Cancelof
TOTAL GRANT AMOUNT REQUESTING*
You may submit corresponding paperwork by uploading to this application or by mail (USTA Middle States, Attn: Mike Kennedy, 1288 Valley Forge Rd., PO Box 978, Ste. 74,

Valley Forge, PA 19482)

If you have any questions please contact Mike Kennedy (Kennedy@ms.usta.com, 484-302-0755)
Should be Empty:

USTA MIDDLE STATES JUNIOR PLAYER COMPETITION EXPENSE REIMBURSEMENT GRANT APPLICATION

Jr. Singles Ranking

Current Year Standings

Required Paperwork