Need-Based Financial Scholarship for Bozeman Youth Cycling
(All information will remain confidential. One application per athlete. Applications must be received no later than April 01, 2019.)
Applicant Name *
Your answer
Date of Birth *
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Grade *
Your answer
Parent/Guardian Name(s)* *
*Person(s) financially responsible for child
Your answer
Mailing Address *
Your answer
City, State, Zip *
Your answer
Phone(s) *
Your answer
Household Income *
*
Please describe any circumstances currently affecting your ability to pay the full registration fee
Your answer
Parent/Guardian Signature(s) *
I hereby certify that my child needs financial assistance from Bozeman Youth Cycling to participate in the program. I hereby certify that the above information is true and correct and acknowledge that failure to complete this entire application and/or submitting false information may disqualify my child from financial assistance.
Your answer
Date *
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