CPRST Foundation Scholarship Form
Email *
Full Name *
Date of Birth *
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Address *
Phone number *
What School Do You Attend? *
Coach's Name *
Name of Coach who recommended this scholarship to you.
Coach's Email Address *
Coach's Phone Number *
Cell Number Preferred
Family Annual Gross Income (Before taxes, All sources, Most recent full year) *
Total Number of Family Members in Household *
Number of Children in Household *
Number of Adults in Household *
Name of Requested Service Assistance (Specific Program, Sport, and/or Activity) *
Start Date of Requested Activity *
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DD
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Amount of Program Fee *
Amount of Fee Requested *
Have you ever applied for CPRST financial assistance? *
Do you qualify for a federal lunch program? *
Has applicant participated in requested program before? *
Have you attempted to receive financial service from another source? *
If yes to the above question, please name the source(s)
Is this need based on a recent financial hardship that is not reflected by being in enrolled in Free or Reduced Lunches at school or current household income level? *
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