Scholarship Application – TKO Premier SC

TKO Premier SC Scholarship Application

Fields marked with an * are required

Player First Name *

Player Last Name *

Email *

Email Confirmation *

Player Birthdate *

Player's League Level *

Coach's Name *

Are you applying for more then one player *

Number of Players in Family in the Club *

Additional Players *

If you have more then one player, please list their First Name, Gender, and Coach.

Do you have players playing in other clubs *

Other Club *

If yes, please list the First Name, Gender and Club they are playing for

Total Financial Request Amount

Please enter the total amount of requested financial assistance. This is NOT the guaranteed awarded amount.

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Parent / Guardian 1

First Name *

Last Name *

Occupation *

Address *

City *

US States *

Zip *

Phone *

Preferred method of contact *

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Parent / Guardian 2

First Name *

Last Name *

Occupation *

Address *

City *

US States *

Zip *

Phone *

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For consideration, all applicants must supply a copy of the prior year's IRS federal form 1040, 1040A or 1040EZ. Please black out all Social Security numbers. If parent 1 and parent 2 file separately, we require copies of BOTH tax returns.

All information submitted will be kept confidential. TKO Premier SC is prohibited from discriminating on the basis of race, color, national origin, or sex.

Tax Forms should be scanned and emailed to:

scholarships@tkopremier.org

I have read and agree *

By checking this box I acknowledge that if I do not include all requested information this application will not be considered.

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Parent / Guardian 1 Employment Status *

Parent / Guardian 2 Employment Status *

Total number of people living in the home *

Annual Total Income *

If Parents / Guardians have filed Federal taxes separately, please combine both incomes.

Financial assistance *

Does your family receive financial assistance from any federal or state agencies?

Agencies

If you are receiving financial assistance please name the agency and type of assistance.

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Other Assets and Liabilities.

Housing Status *

Monthy housing payment *

Estimated home value *

If you own your home provide the estimated value. If you do not, choose Does Not Apply

Home amount owed *

If you own your home provide the estimated amount owed (mortgage). If you do not, choose Does Not Apply

Do you own a second home/ cottage/ land? *

Estimated second property value *

If you own a second property provide the estimated value. If you do not, choose Does Not Apply

Second property amount owed *

If you own a second poperty provide the estimated amount owed (mortgage). If you do not, choose Does Not Apply

Education Expenses *

Please provide College tuition, private school payments, or educational expenses expected in in the upcoming year.

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Use this section to provide any further information that you would like us to consider when determining financial assistance (employment status, unexpected hardships, etc.)

Please explain any extenuating circumstances that have impacted your financial situation short or long term.

Additional Information

Full Name of Person who is completed this form *

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I certify that all of the above information is true and correct. I understand that this information is being provided as a method to assist TKO Premier SC in determining the level of financial assistance that may be awarded toward player fees for the upcoming TKO Premier SC Soccer Season.

I understand that monies provided through this application process will be used to pay player costs, and will not pay for any supplemental expenses associated with participation in TKO Premier SC (travel expenses, team fees, uniforms, etc.).

I authorize the representatives of TKO Premier SC to discuss this request with the team manager/coach, along with board members in an effort to make a determination of what financial assistance may be granted and/or track payments against an established payment plan.

I Agree *

I have read and understand the statement above.

I agree to Volunteer Service *

By submitting this request, I agree that upon approval of financial assistance, I will volunteer at two separate club events for up to 3 hours each. Volunteer opportunities will be communicated by the Board of Directors on an as-needed basis and may include our golf outing, tryout registration, KISS Tournament, club fun night, or other.