US Lacrosse of Northern California - League Athletics
Oakland Lacrosse Club Scholarship Application Important Instructions: 1. All information submitted on this scholarship application will remain confidential to the scholarship review committee. 2. Your completed application must be received no later than 6:00 PM on November 30, 2013. 3. Completed application should be mailed to: OR emailed to: Oakland Lacrosse Club - Scholarships [email protected] c/o Kristin Loo 4020 Reinhardt Dr. Oakland, CA 94619 4. Incomplete or illegible applications will not be considered. If you have questions concerning this application, please email: [email protected] or call Kevin Kelley at 415-613-1525. 5. Scholarship recipients will be notified by December 4th. 6. Any registration fees not covered by the scholarship must be paid by December 10, 2013 or the player’s registration will be dropped. Section 1 - General information: Player’s Name: Player’s Home Address: Player’s Phone#:
Email:
Parent or Legal Guardian’s Name(s): Parent or Legal Guardian’s Daytime Phone #:
Email:
Section 2 - To be completed by the Legal Guardian or Parent of the prospective player. What is your gross annual household income? (Documentation may be requested)_____________________ Amount of scholarship requested?____________________________________________________________ Is the student (player) signed up to receive Free or Reduced Lunch at his/her school?___________________ Please describe the financial circumstances that the Oakland Lacrosse Club should consider as a basis for awarding this applicant a scholarship:
I promise that the financial situation of the player is as stated above. Parent or Legal Guardian (please print)
Parent or Legal Guardian Signature/Date
Oakland Lacrosse Club www.oaklandlacrosse.org
Section 3 - To be completed by all prospective players. Player’s Name: Player’s Date of Birth (mm/dd/yyyy): Player’s Age as of August 31st, 2013: Current School Attending: Current Grade: Additional questions for high school players only: Which team will you be playing on?__________________________________________________________ For new players, why do you want to play lacrosse?
For returning players, when did you first play lacrosse?
How did you become interested in playing lacrosse?
What do you like most about playing lacrosse?
Use the space below to tell us anything else you want us to know about you and how lacrosse has had an impact on your life:
Oakland Lacrosse Club www.oaklandlacrosse.org
Email:
Parent or Legal Guardian’s Name(s): Parent or Legal Guardian’s Daytime Phone #:
Email:
Section 2 - To be completed by the Legal Guardian or Parent of the prospective player. What is your gross annual household income? (Documentation may be requested)_____________________ Amount of scholarship requested?____________________________________________________________ Is the student (player) signed up to receive Free or Reduced Lunch at his/her school?___________________ Please describe the financial circumstances that the Oakland Lacrosse Club should consider as a basis for awarding this applicant a scholarship:
I promise that the financial situation of the player is as stated above. Parent or Legal Guardian (please print)
Parent or Legal Guardian Signature/Date
Oakland Lacrosse Club www.oaklandlacrosse.org
Section 3 - To be completed by all prospective players. Player’s Name: Player’s Date of Birth (mm/dd/yyyy): Player’s Age as of August 31st, 2013: Current School Attending: Current Grade: Additional questions for high school players only: Which team will you be playing on?__________________________________________________________ For new players, why do you want to play lacrosse?
For returning players, when did you first play lacrosse?
How did you become interested in playing lacrosse?
What do you like most about playing lacrosse?
Use the space below to tell us anything else you want us to know about you and how lacrosse has had an impact on your life:
Oakland Lacrosse Club www.oaklandlacrosse.org
