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Program Scholarship Application

2. APRD RECREATION PROGRAM SCHOLARSHIP REQUEST FORM
   Scholarships are provided by a cooperative effort with the Kiwanis Noon Club and the Anacortes Parks Foundation.

   Scholarships are provided by a cooperative effort with the Kiwanis Noon Club and the Anacortes Parks Foundation.

4. Contact Information

6. PARTICIPANT First Name*

7. PARTICIPANT Last Name*

9. PARENT/GUARDIAN First Name*

10. PARENT/GUARDIAN Last Name*

12. Address1*

14. Address2

16. City*

17. State*

18. Zip*

20. Phone Number*

21. Parent/Guardian Email Address*

23. Name of Class or Activity Scholarship Requested for:

25. List all activities you would like a scholarship for this participant.) **Also please be specific as to what program, i.e. Youth Soccer, City League, Boys U-10, etc.*

27. Reason for financial need:*

29. Have you received a scholarship from APRD for a recreation program within the past 6 months?*

    1. Yes
    2. No

30. 
    

31. If a full scholarship is not available are you interested in a partial scholarship?

    1. Yes
    2. No

Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field