Spring 2019 Financial Assistance Request
* Required
Did you receive financial assistance from CASL in the Fall 2018 Season?
*
Yes
No
Player's First Name:
*
Your answer
Player's Last Name:
*
Your answer
Player's Phone Number:
*
Your answer
Gender:
*
Choose
Male
Female
Age Group:
*
Age group you are participating with.
Choose
U9
U10
U11
U12
U13
U15 Non-High School
U16
U19
Community:
*
Choose
Bath
Charlotte
DeWitt
East Lansing
Eaton Rapids
Grand Ledge
Haslett
Holt
Jackson Celtic
Jackson County Western
Jackson NW
Laingsburg
Lansing Soccer Club
Leslie
Mason
Okemos
Olivet
St. Johns
Waverly
Williamston
OTHER
Team Name:
*
Your answer
Coach's First Name:
*
Your answer
Coach's Last Name:
*
Your answer
Coach's Email:
*
Your answer
Amount Requested:
*
CASL allows up to $75/season
Your answer
Reason for Request:
*
Your answer
Person Requesting Request
First Name:
*
Your answer
Last Name:
*
Your answer
Email:
*
Your answer
Phone Number:
*
Your answer
Relationship to Player:
*
Choose
Parent/Guardian
Coach/Asst. Coach/Manager
Other
Address Check Should Be Sent To
First Name:
*
Your answer
Last Name:
*
Your answer
Address:
*
Your answer
City:
*
Your answer
Zip:
*
Your answer
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