DYSA Scholarship Application

Submitted by administrator on Mon, 07/30/2012 - 12:59pm

This application will be reviewed by the DYSA Board of Directors at their next monthly meeting. A DYSA Administrator will contact you with the Board's decision shortly after that meeting.

Player Name: *

Team: *

Player Birth Date: *

Scholarship Applying For:: *

Registration Fee

Team Tournament Fee

Uniform

How much can you afford to play toward your player's fees?: *

PARENT(S)/LEGAL GUARDIAN (APPLICANT) CONTACT INFORMATION

Name: *

Email Address: *

Relation(s): *

Father

Mother

Legal Guardian

Home Phone: *

Work Phone: *

Home Address: *

City/State/Zip: *

Do you agree to volunteer a minimum of 4 hours of service to Durango Youth Soccer during the period you receive assistance?: *

What type of volunteer work would you like to do?: *

EMPLOYMENT: First Parent/Legal Guardian

Are You Employed (if yes, where)?: *

Employer Phone: *

Name of Supervisor: *

How Many Hours per Week?: *

How Many Months per Year?: *

EMPLOYMENT: Second Parent/Legal Guardian

Are You Employed (if yes, where)?:

Employer Phone:

Name of Supervisor:

How Many Hours per Week?:

How Many Months per Year?:

Brief Explanation of Financial Situation:: *

DYSA Scholarship Application

DYSA Sponsors