AM3N Financial Assistance Application
AM3N is a nonprofit organization that is dedicated to creating generational change through athletic opportunities for those needing financial assistance. We are committed to serving community members regardless of age, race, ethnicity, religion, or gender. Financial assistance and fee reductions are available on a case-by-case basis depending on your application and AM3N financial resources.

If you are interested in applying for financial assistance, please complete the application below and supplement it with proper income documentation (plus whatever other documents apply to you). Application information will remain confidential.
Email *
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Applicant's First Name *
Your answer
Applicant's Last Name *
Your answer
Applicant's DOB *
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YYYY
Applicant's Street Address *
Your answer
Applicant's Street Address Line 2 *
Your answer
Applicant's City *
Your answer
Applicant's State *
Your answer
Applicant's Zip *
Your answer
Applicant's Phone *
Your answer
Applicant's Email *
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Street Address *
Your answer
Parent/Guardian Street Address Line 2 *
Your answer
Parent/Guardian City *
Your answer
Parent/Guardian State *
Your answer
Parent/Guardian Zip *
Your answer
Parent/Guardian Phone *
Your answer
Parent/Guardian Email *
Your answer
I/We are applying for financial assistance to help cover costs of: *
Employment Status *
Occupation or Job Title *
Your answer
Name of supervisor and phone number *
Your answer
How many dependent children?  Dependents (up to age 26) must reside at the same address. *
Your answer
How many dependent children?  Dependents (up to age 26) must reside at the same address. *
Your answer
Your Finances
Please describe your current and past financial situation.
Your income from last year *
Your answer
Child support you received last year *
Your answer
Social security payments you received last year *
Your answer
List any income you received from other sources (rent, support from relatives, etc.) *
Your answer
Your total income last year *
Your answer
Your estimated total income for this year *
Your answer
Are you receiving financial assistance from any government or local agency? *
Describe any extraordinary expenses or special circumstance that you are dealing with.  Be specific regarding costs and duration.
Your answer
Additional Documentation
In addition to completing this online form, we will also require the following documents as a part of your application.
Please check the box for each document you will provide. *
Required
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