MARATHON COUNTY YOUTH HOCKEY ASSOCIATION
FINANCIAL ASSISTANCE APPLICATION
Marathon County Youth Hockey offers financial assistance designed to fit each individual’s financial situation in order to give every child an opportunity to participate in our program. However, our program is a non-profit organization and you may be asked to pay a portion of the fees.
The maximum amount that I can pay per month is: $______
STATEMENT OF UNDERSTANDING
Please read and check off each statement and initial at the bottom that you understand.
I understand that Marathon County Youth Hockey is a non-profit organization and that financial assistance is made possible through the generosity of donors and members. / I agree to notify Marathon County Youth Hockey if my financial situation improves, so that my membership subsidy can be re-evaluated, thus providing more opportunities for others in need.I understand my subsidy is only valid for one year. / I understand that scholarships will be awarded on a first-come, first-served basis, subject to available funds and eligibility.
I understand that to obtain my subsidy, I may be required to provide financial documentation, when requested, and I will be afforded at least 30 days to provide information when requested. Failure to do so may lead to revoking my subsidy. / I understand that Marathon County Youth Hockey members receive the same membership benefits, regardless of whether or not they are receiving assistance.
I understand that if my subsidy is revoked or expires, my membership will revert to a full pay membership and the appropriate current membership fees will be charged. I further understand that expiration or revocation of my subsidy does not cancel my membership.
______Please initial that you have read and understand each statement.
Name of Parent or Guardian: ______
Address: ______
Home Phone: ______Cell Phone: ______
Name of Employer: ______
Name(s) and Date of Birth of child/children for whom assistance is being requested:
Name ______Date of Birth ______
Name ______Date of Birth ______
Will you be willing and able to volunteer your time helping Marathon County Youth Hockey program during the season? ______
Have you previously applied for financial assistance with Marathon County Youth Hockey? ______
Are you currently receiving financial assistance for any other non-profit programs? ______
Reason/Background for Financial Assistance Request:
Please email the completed Financial Assistance Application to:
Michele Federici – Treasurer MCYH
or mail to MCYH, PO Box 176 Wausau, WI 54402
Your request will be reviewed by the Marathon County Youth Hockey Association Finance Committee. You will be contacted shortly after with a decision from this board.
I certify that the above information is true and correct.
______
Signature of parent or legal guardian Date
*All personal information will be kept confidential