Charlotte United Palmetto FC FINANCIAL ASSISTANCE ...
Charlotte United Palmetto FC FINANCIAL ASSISTANCE APPLICATION Seasonal Years 2016-‐2017
It is the policy of Palmetto FC to provide soccer opportunities for all players regardless of the ability to pay to the extent that Financial Assistance Funds are available. A parent/applicant must complete this application in its entirety and include required documentation in order for consideration.
Palmetto United will not consider incomplete applications. Financial Assistance covers club fees, not uniform fees or team fees, which are the responsibility of the parent/applicant. Recipients must stay current with team fees in order to retain financial assistance status. This application and all attached documents are confidential.
Applications must be submitted prior to June 15, 2016. NO APPLICATIONS WILL BE REVIEWED AFTER THIS DATE UNLESS APPROVED BY CLUB TREASURER OR PRESIDENT. Player Registration and Notarized SC Medical Release must accompany the completed Financial Assistance Form. You will be required to provide supporting financial documentation. (Be prepared to discuss with a club treasurer if questions arise). Both pages of this agreement are required to be initialed by applicant. Late applications will be considered only if funds are available. Completed applications and supporting documentation should be mailed or delivered to: Palmetto United FC, Financial Assistance, 857 Promenade Walk, c/o UPYMCA, Fort Mill, SC 29708.
There is no guarantee that financial assistance will be approved by Palmetto FC. Based on the number of applications for financial assistance, you may receive full amount of requested financial assistance or a portion of your request based on the information received with this application. Palmetto United will carefully consider all requests. Please note the following guidelines: ● All applicants responsible for a minimum $200 Commitment Fee. This fee covers registration and insurance. ● Commitment fee must be paid at time of team placement. ● All applicants responsible for ordering uniform kit from soccer.com by time of team placement. ● Uniform fee must be paid at time of team placement. ● To be eligible for Financial Assistance, Total Gross Income for the family cannot exceed $40,000. ● One of the following supporting documents must be submitted with this application in order for Financial Assistance to be considered. If you do not have one of these documents, please mark section in this application. 1. A copy of your 2015 Federal Tax Return. 2. A copy of your 2015 W-‐2 from Employer. 3. Two most recent copies of your Payroll stub from current or past employer. ● You may request financial assistance for an amount, not to exceed, 50% of Club Fees. ● If you do not require financial assistance, but want to request an Alternative Payment Plan to the Financial Agreement, please mark accordingly in the section below. ● As a condition of Financial Assistance, you will be required to agree to a payment plan for remainder of club fees owed to be paid through cash in advance of due date, debit from bank account or credit card payment. Details to be included with Financial Assistance Acceptance Letter. ● All applicants receiving financial assistance are required to provide 20 hours of volunteer service during season. ● Commitment fee and service agreement must be approved before team placement. Uniform must be ordered and paid for. All fees must be paid in full and service agreement approved before player will be registered with Palmetto United. Palmetto United FC | 857 Promenade Walk | Fort Mill, SC 29708 www.palmettounitedfc.org
Charlotte United Palmetto FC FINANCIAL ASSISTANCE APPLICATION Seasonal Years 2016-‐2017
I (we) would like to apply for a Palmetto United financial assistance and/or alternative payment plan: I request to reduce my Club Fee by $ Club Fee)
or
_% (May not exceed 50% of
I request to reduce my Club Fee by $
or
_% ($200 Commitment Fee required by applicant)
Payment Plan. # of Months:
(starting July, not to exceed 6 months) and $
per month.
APPLICANT INFORMATION
Child/Player’s Name
Age Group
Parent/Applicant’s Name
Phone
Home Address
City
State
Zip
Email Address (please print legibly)
SUPPORTING DOCUMENTS PROVIDED (PLEASE CHECK)
Copy of 2015 Tax Return
Copy of 2015 W-‐2
Copies of Paycheck Stub(s) _None (please explain)
Explain why applicant should receive Financial Assistance and explain any special circumstances to be considered:
Upon acceptance of financial assistance, player and/or player's parent(s) agree to all terms and conditions of Financial Assistance, and to assist Palmetto United Futbol Club with fundraising or other club functions if asked to do so. The parent(s) fully understand that should their financial situation change that Palmetto United will be notified immediately of such change. Also player/player’s parent(s) are aware that Uniform Fee and Team Fees are the responsibility of the parent/player.
Parent’s Signature:
Date:
Palmetto United FC | 857 Promenade Walk | Fort Mill, SC 29708 www.palmettounitedfc.org
