USATF Georgia Youth Club Travel Grant
Application Form
The Georgia Association Youth Committee will award 16 travel grants for
Track & Field (8) and Cross Country (8)
Please Print or Type
Club Name: ______USATF Club No.: ______
Street Address: ______
City, State: ______Zip: ______
Phone: ______Head Coach: ______Email: ______
Years of USATF Club Membership: ______Years of Individual Membership: ______
Name of athlete(s) you expect will benefit should your club be awarded the 8, XC Grants at $500 each and the 8, Track Field Grants at $1,000.00 each (attach additional sheet if needed): ______
______
Has your club received a USATF Travel Grant in the past? q Yes q No
If yes, what year(s) did you receive the grant?______
Did any of your club’s athletes participate in one or more of the eligible USATF National Championships in 2016? q Yes q No
Which 2016 USATF National Championship competition(s) did your athlete(s) compete in? (Check all that apply)
q USATF Youth Indoor Track & Field Championships
q USATF Youth Outdoor Track & Field Championships
q USATF Junior Outdoor Track & Field Championships
q USATF National Junior Olympic Track & Field Championships
q USATF National Junior Olympic Cross Country Championships
Please list the athlete(s) name and their championship(s) result (attach additional sheet if needed).
______
Did you or your club volunteer at a 2016 Georgia Association Youth Championship? If yes, please describe. ______
The following information is required:
On a separate sheet of paper, please tell us about your club/athlete(s). Specifically, explain how your club has participated in one or more of the five USATF National Championships (as listed above) in the past and, more importantly, how a Georgia Youth Travel Grant did/will impact your club and athletes.
Clubs approved for reimbursement must submit travel receipts before receiving the grant.
Completed applications must be received by January 22, 2017
Email to both: Arlena Epps, Youth Secretary, and Jacqui Collins, Youth Vice Chair of Administration,