STEAMBOAT SOCCER CLUB
APPLICATION FOR YOUTH SOCCER SCHOLARSHIP
Scholarship applications must be submitted prior to the start of the program. All applicable
registration fees must be paid at the time of registration and are non-refundable. The Scholarship
Committee reviews applications and the applicant will be notified of outcome.
Player’s Name: ________________________________ Age: _______ Grade: ________ Gender:
M F
Team ________________________________________
Additional Children playing: (Please list all children for whom you are requesting assistance.)
Player’s Name: ________________________________ Age: _______ Grade: ________ Gender:
M F
Team ________________________________________
Player’s Name: ________________________________ Age: _______ Grade: ________ Gender:
M F
Team ________________________________________
Parents/Guardians Names: _______________________________________________________________
Mailing Address: ______________________________ City/St/Zip: _____________________________
Home Phone: ____________________________ Cell Phone: ____________________________________
Email address:___________________________________________________________________________
MOTHERS WORK # : ______________________ FATHER’S WORK #: __________________________
Total number of Dependent: s ____________ Adults: ___________ Children: ____________________
We need volunteers to support the SSC Scholarship fund. List any volunteer work you participated
in this past soccer season: ________________________________________________________________
List ways you can volunteer your time this year:____________________________________________
What volunteer opportunities are of interest to you?
____Assist at the Tournaments
____Coaching
____chair/co-chair
____Team Manager
____Office work
____fundraising
____Other
____work station
Would the applicant (youth) be willing to be a volunteer in SSC activities?
____Yes
____No
Did the applicant receive a scholarship from the SSC for the previous year?
____Yes
____No
If yes, please give dates and details_______________________________
If no, did you apply?
____Yes
____No
Are you currently receiving assistance in any of the following areas? Please check:
____Equipment/Uniform
____Reduced Fees
____Other
Please check current household Income bracket:
$0-$50,000_______
$50,001-$75,000________
$75,001-100,000________ $100,001- above_________
Why do you feel your child should be awarded financial assistance?
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If you are not approved for financial assistance, will that limit your child from participating this
year? Please explain.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Are there any additional comments or extenuating circumstance? Please explain.
________________________________________________________________________________________
________________________________________________________________________________________
I hereby certify that all the above information is true and correct to my knowledge, and that I have
read and understood the Youth Soccer Scholarship Policy, and that the Steamboat Soccer Club
reserves the right to terminate scholarship funds at any time after Scholarship Committee review.
SIGNATURE OF PARENT/GUARDIAN____________________________________________
Please forward application to:
Steamboat Soccer Club
PO Box 770661
Steamboat Springs, CO 80477
[email protected] (office #) 970-870-1520