MBAA Pay to Play Scholarship Application

MBAA'S Pay to Play Scholarships will be granted to visually impaired Jr. High - H.S. age student athletes only.
Priority will be given to youth who have attended at least one of the MBAA's Sports Education Camps in Kalamazoo.
Athletes may apply only once per year, but may re-apply in subsequent years whether they have or have not received a scholarship previously.
A limit on the amount any one person will be awarded will be established - likely in the \$200 range - but that may vary on an "as needed" basis.

Athlete Info:

First Name Last Name Birth Date (mm/dd/yy)

Gender Visual Acuity

Family Contact info:

Name of parent or guardian you live with

Street address (include apt no. if applicable) City State ZIP code

Email address Home Phone Cell Phone

Sport Team info:

What sport do you plan to participate in?
Do you have previous experience with this sport?    Yes    No
Have you previously participated on a team for this sport? Yes    No
Do you expect to be on the Varsity squad or JV?    Varsity    Junior Varsity Not sure

What fee are you required to pay to participate?
How much do you need for required equipment?)

What school district are you in (city, township, etc.)?
What school will you attend? (or are already attending)
What grade are you or will you be in?
What season is this sport at your school (or club)?
By what date do you need this application processed? (mm/dd/yy)

Name of coach (or other contact person) from the team: Is this person the coach? Yes No
Title / role of contact (if other than the coach)
Email address for coach / other contact:
   Phone number for coach / other contact:

If the sport you plan to participate in is a club sport and not a school sport, please give a brief description of the club in the Personal Statement box below.

If equipment is needed:
If it's equipment you need to purchase (vs a mandatory fee) describe what it is you need.

Personal Statement:
Do you currently receive free or discounted school lunches? Yes No
Please provide a short statement describing your financial need situation and how the scholarship would help. (Please use 8 lines or less.)