Empower Play Inc Funding Application
Apply for funding
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Имејл адреса *
Parent/Guardian first and last name *
Phone Number *
Street Address and Postal Code *
City, Province *
Net Household Income (We may as for income verification) *
Number of Dependents *
Your E Mail Address *
Athlete/Artist first and last name *
Athlete/Artist Date of Birth *
ДД
/
ММ
/
ГГГГ
Name of School Attending
For which type of program are you applying for funding? *
Name of program's governing organization *
Name of program
Team Manager/Treasurer Name *
Head Coach/Instructor's Name *
Head Coach/Instructor's Phone Number *
Level of Competition *
Cost of Registration
Estimated other costs Incurred *
Number of years experience in this program *
If chosen, is this applicant willing to... *
Обавезно
If we can only provide a partial registration fee, are you able to fund the rest of the fees? *
Past individual/team awards or recognition
Tell us why we should choose this applicant for a grant to participate in their program
If chosen, to whom do we write the cheque out for? We do not write personal cheques.  All cheques are made out to the organization or program.
Копија одговора ће бити послата имејлом на адресу коју сте навели.
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