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low income scholarship application

low income application

Low Income verification application. Please be sure to fill out the form completely and submit your income verification to admin@gripspintennis.org

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

What services are you interested in?

Private Lessons

Junior Clinics (Classes)

Adult Classes

Ball Machine Rental

How did you hear about us?

Annual Combined Household Income

Please provide your combined household income for the previous year (year prior to current). This should be based on your last year's income tax filing (usually line 15). This should be done for all working adults in your household.

Addition Information

Please provide any additional information needed to approve you for our low income program. (eg. provide lease information for section, SNAP program, etc.)

Agreement

I certify that I am applying for the low income rate because I am considered low income based on the criteria listed on this form. This application is the first step of getting verified. You will need to submit proof of income before you are enrolled in the program. I certify that all documents submitted as income verification are my own, true and accurate. Any falsified or fraudulent documents will be reported to the proper authorities and you will be disqualified from applying.

I Certify