2012scholarship by hJqV00Q4

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									The Monroe Youth Football Association strives to bring sport experiences to every child interested in
participating. If the fees required to participate in Youth Football present a family hardship, the MYFA
Board makes the following options available:

      Option 1 (open to all income ranges): Payment plan with no additional fees
      Option 2 (open to households receiving Public Assistance): Partial scholarship
      Option 3 (limited openings to households below the Federal poverty level): Full scholarship

Options 2 and 3 require proof of hardship and all applications will be confidentally reviewed by a
scholarship committee formed from non-board members. The funds provided for scholarships are
limited; decisions will be needs-based.

                     All scholarship applications must be submitted by July 1, 2012.

                               Player 1 Information – Please Print Legibly
 First Name                                              Last Name
                                                      School Attending
Date of Birth
                                                            in Fall
                                                      Team Last Year,
 Returning
                                                        If Applicable

                               Player 2 Information – Please Print Legibly
 First Name                                              Last Name
                                                      School Attending
Date of Birth
                                                            in Fall
                                                      Team Last Year,
 Returning
                                                        If Applicable

                                Parent Information – Please print legibly
First Name                                             Last Name

First Name                                             Last Name
  Mailing
 Address
 City & Zip
  Phone                                                Alt Phone

   Email
____Option 1 – Payment plan

Our fees for the 2012 season are $235 for one player, $435 for two players and $635 for three or more
players. Fill out the section to indicate how you will pay for the remaining balance.

        ____ Pay in full by July 15

        ____ Pay in three monthly installments paid in full by Sept 15 using post-dated checks
       One Player - $78.33 by July 15, $78.33 by Aug 15, $78.33 by Sept 15
       Two Players - $145 by July 15, $145 by Aug 15, $145 by Sept 15
       Three Players - $211.67 by July 15, $212.67 by Aug 15, $211.6 by Sept 15

    ___ Other (Must be approved by Monroe Youth Football Board)

Monroe Youth Football Board must approve any payment arrangements. Any payments that are approved must be paid in full by the date
indicated. Any late or missed payments may result in your player(s) sit out games until the payment can be made.

____Option 2 & 3 - Reduced tuition

    1. Counting yourself, how many people are live in your home? ___________________________________________

    2. How many children live with you? ________________________________________________________________________

    3. What is your monthly income before taxes from all sources? ___________________________________________

    4. Does your household receive State or Federal assistance? If so, please
       specify________________________________________________________________________________________________________

    5. Please indicate any extenuating circumstances we should consider. (Use the back if need more
       room.)
       _________________________________________________________________________________________________________________
       _________________________________________________________________________________________________________________

____Option 3 – Full scholarship
Note that any application for a full scholarship will require proof of income. Full scholarships will only be
considered for households at or below the Federal poverty level.


I certify that all information I am providing above is correct to my knowledge. I understand that if at any
time it is derermined that the information I provided was false, it may disqualify my application for
Scholarship and full fees will apply.

       For Option #2, please provide proof of Public Assistance
       For Option #3, please provide proof of income and(if applicable) proof of Public assistance


Signature ___________________________________________________ Date ________________

								
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