Kitchener-Waterloo
Youth Basketball Association
Scholarship Application
Please complete this application and return it to [email protected] by June 3, 2017.
Name:
Home Address:
Phone Number:
Current Secondary School:
K-W YBA Reference Name:
Phone:
➢ Involvement in YBA activities: (fill in all sections that apply)
YBA House League Player:
Number of Seasons:
YBA House League Coach/Assistant Coach:
Number of Seasons:
YBA House League Referee:
Number of Seasons:
Viper Player:
Number of Seasons:
➢ Outline your involvement in the YBA starting from this current season:
I have applied and been accepted at the following Post-Secondary Institution:
Name of Institution:
Course Program:
Answer questions on next page as fully as possible
-21.
How has the K-W YBA benefited you as a player, a student and a person?
2.
What contributions have you made to the K-W YBA?
I certify that the information above is correct.
Date:
Signature of Applicant: