EVERYONE PLAYS
Recreation Program Scholarship Application
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EVERYONE PLAYS
It is our belief that all children should have access to participate in youth sports and programs without cost being a hindrance on whether a family enrolls their child in a specific program. The North Tonawanda Youth Board, in association with the NT Department of Youth, Recreation & Parks has put into place a scholarship program providing funding for low income families to help cover the cost of enrollment in youth programs.


Please fill out the application below and include… Copy of 1040 tax form from most recent year OR proof of acceptance/enrollment in SNAP or Free Lunch Program. (You can send a picture of your 1040 tax form to adomaradzki@northtonawanda.org)

FAQ's
HOUSEHOLD INFORMATION
To be completed by head of the household requesting assistance
Name of Parent/Guardian *
Phone *
Address *
Must be a North Tonawanda Resident with a child who is in the North Tonawanda School System
Email Address
Are you employed? *
Name of Employer
Household MONTHLY gross income *
Household YEARLY gross income *
Are you currently enrolled in the SNAP (Supplemental Nutrition Assistance Program)? *
Are you currently enrolled in the Free/Reduced Lunch Program? *
Number of ADULTS in the household? *
Number of CHILDREN (18 & under) in the household? *
HOUSEHOLD MEMBER INFORMATION
In the spaces below, please list the names, date of birth and programs they are interested in the space provided.
Household Member #1 *
Please name, date of birth and the programs interested in
Household Member #2 *
Please name, date of birth and the programs interested in
Household Member #3
Please name, date of birth and the programs interested in
Household Member #4
Please name, date of birth and the programs interested in
Household Member #5
Please name, date of birth and the programs interested in
Household Member #6
Please name, date of birth and the programs interested in
Household Member #7
Please name, date of birth and the programs interested in
Household Member #8
Please name, date of birth and the programs interested in
CERTIFICATION OF INFORMATION PROVIDED
I certify that all of the information provided on this form is true and accurate. I understand that this information will only be used for the review and authorization of youth program assistance, and understand that the information provided will be verified as part of the acceptance of the application. Any deliberate misrepresentation of the information may result in denial of future scholarship enrollment.
Do you acknowledge the above information is true? *
By answering "yes" and submitting this application you agree to the above statement.
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