SPECIAL EVENT APPLICATION

Minot Soccer Association Financial Assistance Program – SPECIAL EVENT APPLICATION Minot Soccer Association (MSA) has established a financial assistance program for soccer players who are recognized for special achievement and invited to a major soccer event that will be substantially more expensive than usual travel soccer events (e.g. an international event.). Submission of this application is assumed to be in good faith and truthful and will be reviewed in a strictly confidential manner by board members. It is extremely important that financial assistance applications are handled timely. Status will be determined and communicated via letter as soon as possible. To apply for financial assistance for a special event, please complete the following: General Information Application Date:

Player Name: Player Address:

Player DOB: Player Phone: Player Email:

Special Event Details Special Event Name: Special Event Location: Fees & resources required to attend: Family Information Mother/Guardian Name: Mother/Guardian Email: Father/Guardian Name: Father/Guardian Email:

Special Event Date:

Mother/Guardian Address:

Mother/Guardian Phone:

Father/Guardian Address:

Father/Guardian Phone:

Other fund raising activities planned: Examples of active service to community &/or support of soccer as a positive experience:

On back of this form, please provide any additional information related to this event or family’s financial situation that may assist the MSA Board of Directors in their decision. Application should be submitted via mail and addressed as follows: Minot Soccer Association Attn: Financial Assistance Committee PO Box 1392 Minot, ND 58702

Parent/Guardian signature

Player Signature

Date