SCTPF Junior Player Grant

Date:

Grant Category

Name

USTA Membership #

Street

City

State

Zip

Father's Name

E-mail

Occupation

Employer

Mother's Name

E-mail

Occupation

Employer

Annual Family Income (please check one)

Under $25,000 $25,001 - $50,000 $50,001 - $75,000 $75,001 - $99,000 $99,000-$124,000 $125,000-$150,000

Do you rent or own your home?

Rent Own

Number of children in family (including applicant)

Do children receive assistance from any other source?

If yes, please explain:

Coach's name

Address

Phone

Email

Please explain justification for request and expense(s) for which aid will be used:

South Carolina Standing (if applicable, but required for Competition and High Performance Grants)

Southern Standing (if applicable, required for High Performance Grant)

National Standing (if applicable)

Age Division

Tournament Schedule for this calendar year:

Do you have any current suspension points?

Yes No

If yes, how many? Note: If you have 4 or more suspension points you are not eligible for funding until such time as those points drop below 4.

Have you been suspended during the current or previous calendar year? Note: If the answer is yes, you are not eligible for grant funding this year.

Yes No

Has your parent/guardian been suspended during the current or previous calendar year? Note: If the answer is yes, you are not eligible for grant funding this year.

Yes No

Player's Statement - What does sportsmanship mean to you and how do you demonstrate it in your game?

Allotment of Expenses

Equipment:

Tournaments & Travel:

Instruction:

Grand Total:

By signing, you acknowledge that your parent(s)/guardian(s) approve of this application, and affirms that the information provided is accurate.

Player Signature Clear

By signing as the parent or guardian, you acknowledge that you approve of this application and affirm that the information provided is accurate.

Parent/Guardian Signature Clear

Date: