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1216 CITY OF EVERETT

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U.S.A. forms for City of Everett

BROWSE CITY OF EVERETT (WA) FORMS

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s/#common/Recreation/FORMS/SCHOLARSHIP/Scholarship Application 2019-2020
CITY OF EVERETT
PARKS AND COMMUNITY SERVICES
Recreation Classes
Scholarship Application 2019-2020 School Year
It is part of the mission of the Everett Parks and Community Services 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 Community Foundation of Snohomish County
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 as their residence.
Scholarships can only be used for Everett Parks & Community Services-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 (2) youth swim
sessions per quarter). Gymnastics programs are not eligible.
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, or Letter from
Social Security explaining assistance. Whichever documentation you choose MUST have the name of the person
applying/receiving the scholarship on it.
Return the application to:
Everett Parks and Community Services
Recreation Office @ Forest Park
802 E Mukilteo Blvd
Everett WA 98203
Call (425) 257-8300 ext. 2 for assistance with the application.
s/#common/Recreation/FORMS/SCHOLARSHIP/Scholarship Application 2019-2020
*Family Income Guidelines
Family Size
1
Gross Family Yearly Income
$23,107
2
$31,284
3
$39,461
4
$47,638
5
$55,815
6
$63,992
7
$72,169
8
$80,346
*Updated 8/06/19
Based upon July 1, 2019-June 30, 2020 DSHS Needs Standards for Cash
Assistance and school district guidelines for free/reduced lunches.
Please provide all requested information.
Name
/
Birth date
Address
City
ZIP
Employer
Home Phone
Work Phone
$
Names and birth dates of those requesting scholarships: (circle M/F)
1.
M / F Birth date
2.
M / F Birth date
3.
_________________________________________
M / F Birth date
4.
_________________________________________
M / F Birth date
5.
M / F Birth date
6.
M / F 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 Community
Services staff may verify the information on the application.
Signature
Date
Email ______________________________________________________________
APPLICATIONS CANNOT BE PROCESSED WITHOUT PROOF OF INCOME.
For Departmental Use
Approved/Denied
Staff
Date
Supervisor signature
Terms of Approval:
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1216 CITY OF EVERETT

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Completed 12 July 2020

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