TAS Scholarship Application
Please fill out the following form as thoroughly as possible to help us determine if you qualify for a TAS scholarship.
Email address *
What is your name (if you are applying on behalf of someone else)?
Your answer
Are you applying on behalf of an individual, family, or a group? Select *
Name (of participant) *
Your answer
Email *
Your answer
Address *
Your answer
Phone number
Your answer
What is the total cost of the program the participant, family, or group will engage in?
Your answer
What is the total percentage of scholarship being requested by the participant, family, or group will engage in? *
Who is your current employer? (of the person who takes care of the finances)
Your answer
What is your current job title?
Your answer
How long have you been with your current employer?
Your answer
Are you part of a single parent household?
How many people are in the household?
Your answer
How many children are in the household?
Your answer
How many people with different abilities are in the household?
Your answer
How many family members earn an income in the household?
Your answer
What is the percent of household income related to long-term medical expenses?
Your answer
Select any program(s) that the participants, family, or group may currently be receiving assistance from.
List any other assistance programs the participant, family, or group may currently be receiving assistance from.
Your answer
How will the requested scholarship help the participant, family, or group?
Your answer
Describe what will be gained by participating in Teton Adaptive Sports programs.
Your answer
Describe any financial burdens or additional factors that Teton Adaptive Sports should consider when assessing this scholarship application.
Your answer
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