Randy Modjeska Scholarship Application
This is a scholarship that was set up in the memory of Randy Modjeska to provide opportunities for all children to take part in sports ministries at Trinity on Jackson. Please complete the application below.
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Parent Name *
Street Address *
City *
State *
Zip Code *
E-mail address *
Phone Number *
Child Name *
Grade *
2nd Child Name (if applicable)
Grade
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3rd Child Name (if applicable)
Grade
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In the box below, please give us any information we might need to explain the circumstances for your request for assistance. This information will help as we make decisions regarding the distribution of scholarship funds to those who have applied for assistance. We occasionally ask our church community to provide funds to support scholarships so your child(ren)'s first name and last initial may be shared in a sponsorship campaign. *
The registration charge for this league is $80.00 for the first child and $65.00 per additional child. Please select an option below for what fits best with your budget. *
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