Scholarship Application

Easton Youth Hockey Association
Scholarship Application

A separate scholarship application must be submitted for each player. Application should be submitted by the registration deadline (OCT 15th). A limited number of scholarships are available on an annual basis.

Based upon the degree of need, EYHA will award up to 50% of the total house registration fee for an accepted scholarship applicant. EYHA reserves the right to limit the amount of financial aid awarded to a player.

Each application must be accompanied by the following attachments:

· Copy of the parent(s)/guardian(s) current year 1040EZ, 1040, or 1040A U.S. IRS tax form.

· Completed registration forms.

Player Name ________________________________________Address____________________________________

City _____________________________________State______Zip_________Phone Number___________________

Parent/Guardian(s) Name________________________________________________________________________

Address (if different) __________________________________________City_______________State______Zip____

Daytime Phone____________________Evening Phone_____________________Email_______________________

List Ages of Household Dependents________________________________________________________________

Has anyone in your household volunteered time to support EYHA in the past? Yes No

Would you be willing to volunteer time this season? Yes No

Total amount you can pay toward the total registration

fee: $_____________________________________________

INCOME (Please list the total income received by parent(s)/guardian(s))

Parent/Guardian Name	Income (salary, child support, etc.)	Amount Received Monthly

Please give a brief statement for reasons for applying for assistance. List or explain any additional financial circumstances that could impact the Board of Director’s decision (i.e. dependent children in secondary education, dependents with disabilities, recent job layoffs, etc).

_____________________________________________________________________________________________

I, the undersigned, understand all information given will be kept confidential, and that the information on this application is accurate and true to the best of my knowledge.

_____________________________________________________________________________________________

Parent Signature Date EYHA Approval Date

EYHA Scholarship Program Policies

Some children may be unable to participate due to economic hardship. The EYHA Scholarship Program provides financial assistance to reduce league fees.

1. Need is the primary criterion upon which applications are considered.

2. An application for a scholarship must be submitted between May 1^st and October 15^th of the current hockey season. Scholarship deadline is OCT 15TH.

3. Each application must be accompanied by the following documents:

a. Copy of parent(s) or guardian(s) current year 1040EZ, 1040, or 1040A U.S. IRS tax form.

b. Completed registration forms for the season.

4. This program is limited to financial aid for paying league fees.

5. EYHA and the Board of Director’s have the right to limit the amount of financial aid awarded to a player.

6. All applicants must be under 18 years of age.

7. Based upon the degree of need, EYHA will award only up to 50% of the total house league fee for an accepted scholarship applicant.

8. A limited number of scholarships are available on an annual basis.

Scholarship Aid Process:

1. Applications will be received and reviewed by the Board of Directors.

2. The applicant will be contacted by a member of the Board of Directors with its decision.

3. Formal documentation will be mailed to applicant stating the Board of Directors decision.

Applications and attachments must be mailed and postmarked from May 1^st to Oct 15^th of current hockey season:

EYHA

P.O. Box 1793

Westerville, OH 43086-1793

All information submitted will remain confidential to the Board of Directors and kept on file only as long as by law and then destroyed.

For EYHA Use Only

Player Name & Division ________________________________________________________

Total Player League Fees_______________________________________________________

Recommendation: EYHA awards $_______________________________________________