Coach Dylan's Scholarship Application
This application will be reviewed to provide financial coverage for youth soccer session fees at Arizona Sports Complex by the Scholarship Committee.  
Membership and uniform kit will be the responsibility of the member.  
If chosen, this scholarship can only be applied for once every six months.  If you need financial assistance after the initial acceptance, a payment plan can be arranged for future sessions. If you chose a payment plan you agree to have a debit/credit card on file with ASC and will complete a payment schedule agreement to fulfill your payment obligation. 
*Please note that the application must be completed at least 7 days prior to the registration deadline of the session.  If it is not, then it will be considered for the following session.  All session dates can be found on the website.
Sign in to Google to save your progress. Learn more
How did you find out about our scholarship? *
Full Name *
Child's Name *
Marital Status *
How old is your child? *
Child's Gender *
Income *
Mailing Address *
Contact Phone Number *
Email Address *
Does child live in your house full-time or part-time? *
Will you have consistent transportation for practices and games? *
Does your child participate in other extra curricular activities? If yes, please provide activity name and frequency. *
Are you willing to pay for the membership and uniform if the scholarship covers the session fee? *
If you can not pay the full amount for the membership and uniform at the time the scholarship is awarded, do you agree to keep a debit/credit card on file and create a payment schedule agreement with ASC for payments to be taken out to fulfill your financial obligation? *
Why are you requesting this scholarship?  Please be as detailed as possible regarding any specific reason for requesting this financial assistance.  *
If approved, are you willing to sign a contract that you will attend all practices and games unless illness or injury occur.  This is in order to maintain the scholarship. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report