2018-2019 NWYO Financial Assistance Application
This form is to be completed by applicant and parent/guardian. A sum of money is set aside each year to assist participants who might otherwise be unable to participate in specific events. If you are applying, please fill in the information requested completely by August 19, 2018. The NWYO board ensures confidentiality of this application. You will be notified of the decision by September 1, 2018.
Email address *
Student First Name *
Your answer
Student Last Name *
Your answer
Student is a 2018-2019 member of: *
Student is applying for: *
Student Address (house number and street)
Your answer
Student City, State, Zip
Your answer
Student Date of Birth *
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Student Grade in School *
Total number of years student has participated in NWYO *
Your answer
Total family annual income from all sources *
Your answer
Total number of dependents in family *
Your answer
Please describe the circumstances which necessitate the application for financial assistance *
Your answer
Signature of parent/guardian (by typing your name below you indicate that all information in this application is accurate) *
Your answer
Today's Date *
MM
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DD
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A copy of your responses will be emailed to the address you provided.
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