Scholarship Application

Player Information

Player Name *

First

Last

Team Age Group *

Team Gender *

Team Type *

Date of Birth *

Email Address *

Phone Number *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Educational Information

School Name *

School City *

GPA/Percentage/Grades *

Parent/Guardian Information

Parent/Guardian Name *

First

Last

Parent/Guardian Relationship to Player *

Parent/Guardian Phone *

Parent/Guardian Email *

Parent/Guardian Employer *

Additional Parent/Guardian Information

Additional Parent/Guardian Name *

First

Last

Additional Parent/Guardian Relationship to Player *

Additional Parent/Guardian Phone *

Additional Parent/Guardian Email *

Additional Parent/Guardian Employer *

Additional Child Information

Additional Child Name *

First

Last

Additional Child's Club Name *

Additional Child's Age *

Additional Child's School *

Financial Information

What is your current financial situation? *

Please explain your current financial situation: *

What type of income does your family have? *

Please explain the details of your household income: *

Do you have a current year completed tax form? *

How many people are in your Household (Include all children, adults, and adult children)? *

How many years has your family been with San Juan? *

Enter Team Names *

Please state your reason(s) for requesting financial aid from San Juan Soccer Club: *

Have you ever been a volunteer for San Juan Soccer Club? *

Additional volunteer hours are a requirement for scholarship recipients. Are you willing to volunteer or work for San Juan Soccer Club *

Certification and Agreement

Checkboxes *

I certify that all the information provided is accurate and truthful.

Checkboxes *

I agree to comply with the scholarship terms and conditions.

Signature *

Clear Signature

Date of Signature *

SAN JUAN SC