AYSO Region 64
Through the generosity of volunteers and donors, AYSO Region 64 can offer a limited number of scholarships to families so their kids can play soccer. Our goal is to help kids have more opportunities to play soccer. Our volunteers, our families make AYSO a great organization. We ask that you volunteer and follow-through on your volunteer commitments. If you have questions about this form, please email
Parent/Guardian 1 - Name First and Last
Parent/Guardian 1 - Email Address (skip if same as above)
Parent/Guardian 1 - Mobile Phone Number
Parent/Guardian 1 - Profession/Job and Company
Parent/Guardian 2 - Name First and Last
Parent/Guardian 2 - Email Address
Parent/Guardian 2 - Mobile Phone Number
Parent/Guardian 2 - Profession/Job and Company
Estimated Monthly Household Income
Less than $4,000
$4,000 - $6,000
$6,000 - $8,000
$8,000 - $10,000
Decline to Answer
$10,000 - $15,000
More than $15,000
Scholarship Child 1 Name
Child 1 Gender
Child 1 Birth Year
Scholarship Child 2 Name
Child 2 Gender
Child 2 Birth Year
Scholarship Child 3 Name
Child 3 Gender
Child 3 Birth Year
Reason for request (Check all that apply)
Other information you would like to add
Please type your first and last name below to certify the information in this form is true and correct
AYSO is a volunteer run organization
We recognize families have many reasons to apply for a scholarship or financial aid. AYSO is volunteer run. We ask that scholarship families take at least 1 or more volunteer jobs to help run a successful soccer program. If you can not volunteer your effort or time, please be clear when communicating with the volunteer coordinator or your team. Your volunteering will not affecting your application.
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