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CITY OF EVERETT PARKS AND RECREATION Recreation Classes Scholarship Application 2015-2016 School Year It is part of the mission of the Everett Parks and Recreation Department to offer Everett area residents, regardless of abilities, the opportunity to participate in diverse, challenging, and high-quality recreation programs that are accessible and affordable. We provide scholarships to those who might not be able to participate because of income. Funding for scholarships is provided through the Greater Everett Community Foundation. General Policies & Guidelines • To be eligible for a scholarship you must meet the Family Income Guidelines stated (see second page). You will be required to submit proof of income. This will only be used for determining eligibility. • Applicant must have an Everett address • Scholarships can only be used for Everett Parks & Recreation Department sponsored activities. • Based on available funds, applicants will be funded on a first-come, first served basis. • Qualified applicants will receive a 70% reduction of the single program fee, up to $70. Applicant will be required to pay the difference of the activity registration at the time of registering. • Applicants meeting the eligibility guidelines may be awarded a scholarship for one class/program per quarter per person, based on availability. (Exception: eligible applicants may receive a scholarship for two swim sessions per quarter.) How to Apply Complete the application. Enclose proof of income as required from one of the following sources: copy of your child’s free or reduced lunch letter; letter from DSHS explaining current assistance status, previous year’s income tax return. Whichever documentation you choose MUST have the name of the person applying/receiving the scholarship on it. Return the application to: Everett Parks and Recreation Department Recreation Office @ Forest Park 802 E Mukilteo Blvd Everett WA 98203 Call (425) 257-8300 ext. 2 for assistance with the application. ---PAGE BREAK--- *Family Income Guidelines Family Size 1 Gross Family Yearly Income $21,775 2 $29,471 3 $37,167 4 $44,863 5 $52,559 6 $60,255 7 $67,951 8 $75,647 *Updated 9/1/15 Based upon July 1, 2015-June 30, 2016 DSHS Needs Standards for Cash Assistance and school district guidelines for free/reduced lunches. Please provide all requested information. Name (Name of head of household requesting funds) Address City ZIP Employer Home Phone Work Phone Total household gross income $ Total family members Names and birth dates of those requesting scholarships: 1. Birth date 2. Birth date 3. Birth date 4. Birth date 5. Birth date 6. Birth date I certify that all of the above information is true and correct and that all income is reported. I understand that this information is being given for the receipt of financial aid; and that Everett Parks and Recreation staff may verify the information on the application. Signature Date APPLICATIONS CANNOT BE PROCESSED WITHOUT PROOF OF INCOME. For Departmental Use Approved/Denied Staff Date Supervisor signature Terms of Approval: