Financial Hardship Scholarship Application

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					                                                                                                            Financial Hardship
                                                                                                        Scholarship Application



                                                                         Our Mission
H   orses and the Handicapped of South
                                                                To enable the handicapped to improve
Florida (H&H) is committed to bringing
this wonderful therapy to our                                    physically, mentally and emotionally
community. We are committed to
sharing this wonderful therapy with all                         through the use of therapeutic riding
those who will benefit from it. Our
program fees do not cover our costs.                                    and equine activities.
W e d o t h i s t o m a ke t h i s m o r e a c c es s i b l e
t o       m o r e               p e o p l e .

H&H is a non-profit organization and
will grant scholarships based upon
financial need as long as funds are
available. We raise these funds through
our annual fundraisers and grant writing.                                                                Phone:(561) 989-9462; (954) 974-2007
                                                                                                         Fax: (954) 974-6119
Scholarships are awarded on an annual                                                                    E-mail: HandH@HandHMagic.org
basis. All applicants will be required to
pay some amount towards this service as
well as volunteering their time; thus
                                                                         Tradewinds Park                 PO Box 273542
                                                                                                         Boca Raton, Florida 33427-3542
allowing more individuals to receive the                             Coconut Creek, Florida
b e n e f i t s o f o u r t h e r a p y .                                                                Facilities-Tradewinds Park North
                                                                     Www.HandHMagic.org                  3600 West Sample Road
                                                                                                         Coconut Creek, Florida 33073
                           FINANCIAL HARDSHIP SCHOLARSHIP APPLICATION
                                          In order to process please submit with the following:
                 A) most recent year’s Federal income Tax Form ~ B) $25.00 yearly membership fee
            TO BE COMPLETED BY PARENT/GUARDIAN, IF APPLICANT IS UNDER 18 YRS OF AGE
                                                                                 DATE _________________
STUDENT NAME____________________________________________________BIRTHDATE___________________

ADDRESS________________________________________________CITY/ZIP____________________________________________

HOME PHONE______________________CELL__________________E-MAIL__________________________________

FATHER: _______________________________________________                 MOTHER: ___________________________________________

ADDRESS (IF DIFFERENT): _______________________________ADDRESS (IF DIFFERENT): ______________________________

OCCUPATION: ________________________________________ OCCUPATION: _________________________________________

EMPLOYERS NAME: _________________________________                  EMPLOYERS NAME: __________________________________________

PHONE: ____________________________________________                  PHONE: ____________________________________________________


                         VERIFICATION OF EMPLOYMENT AND TAX RETURN MUST ACCOMPANY THIS APPLICATION

   LIST TOTAL MONTHLY FAMILY INCOME AND EXPENSES FROM ALL SOURCES

   Wages (GROSS)               ______________               Rent           ______________     Social Security     ______________

   Rental Income               ______________               Mortgage       ______________    Other Expenses ______________

   Child Support/Alimony ______________                     Utilities      ______________ Car Payment           ______________

   Unemployment/Workers Comp              ______________

   Please attach information on other extraordinary expenses not covered on form.
   Annual Cost: Group Therapeutic riding $900 ~ Private Therapeutic Riding $1150 ~ Private Hippo-therapy $1250
    Volunteers play a significant role in the success of our programs. As apart of qualifying for a scholarship, you are required to
   volunteer 1 hour per month. Please circle one or more that you’d like to volunteer.
   Volunteer Committee          Parent Committee            Office            Barn             Maintenance               Lessons
   Other__________________________________


                        Scholarships are applied for on a yearly basis – Fall, Winter and Spring Sessions

If you do not agree with the decision that has be made on the status for this application. You have the right to appeal. To appeal, you must
contact the scholarship committee through H&H _


SIGNATURE ______________________________________________________ DATE_________________


                                           Office use only
Amount Granted_______________                                 Date_________________


                          Session:      FALL       WINTER            SPRING