Weddington Middle School Athletic Booster Club Hardship Scholarship Application
Athlete’s Name: ________________________________________________________________________________ Parent / Guardian Name: _____________________________________________________________________ Address: ________________________________________________________________________________________ City: _______________________________________________ Zip Code: ______________________________ Home Phone: ______________________________ Cell Phone: _______________________________________ Email Address: _________________________________________________________________________________ Athlete’s Grade: ______________ Sport Playing: _________________________________________________ Parent/Guardian Signature: ____________________________________________ Date: ____/____/_____ PLEASE INCLUDE: A Written Request from Parent / Guardian AND ONE OR MORE OF THE FOLLOWING Documentation showing receipt of assistance (i.e. Food Stamps, Medicaid, SSI, Foster Care, WIC, etc) Written Recommendation by school representatives, Social workers, or other social services representatives Documentation demonstrating immediate financial hardship
For WMS ABC Use Only Approved ____________ Disapproved ____________ Amount Awarded $___________________
Weddington Middle School Athletic Booster Club Hardship Scholarship Application
TERMS AND CONDITIONS By signing this form, I certify that the above information is correct to the best of my knowledge. I understand that the Weddington Middle School Booster Club, through awarding of a scholarship, is not liable for any injury occurring during the participation in the sport for which the scholarship is awarded. Scholarships will not be paid to the individual, nor will any money be refundable to the individual. Scholarships awarded by the Booster Club are for fees only. Recipients are responsible for any equipment and uniforms or pieces of uniform required for participation which will remain in the possession of the scholarship recipient after the end of the season. In addition, scholarships do not include any spirit wear items.
Each scholarship application will be considered on a case by case basis by the Weddington Middle School Booster Club Treasurer and President. The application is considered confidential and will not be shared with anyone other than the representatives listed above. I understand that if any statements submitted are later determined to be inaccurate, it may immediately terminate my child’s privilege to benefit from a scholarship and/or participate in the Weddington Middle School Booster Club sponsored sports programs. By signing below, I understand and agree to the above conditions. Parent / Guardian Signature: ______________________________________________________________ Date of Application: _________________________________________________________________________