Financial Assistance Application

This form is designed to gather information from the family requesting financial assistance. Please complete every section in it's entirety, if anything is left blank or not provided your application will be rejected. In order for your application to be considered, Port Orange Soccer Club requests a copy of your most recent tax return. In the event the board of directors approve your financial assistance, the family will be responsible to make all payments on time as agreed upon and will be required to donate 10 hours of service back to the club through the full fall/spring season. By submitting your application you are agreeing to the conditions as outlined at the end of the application. Thank you.

Parent/Guardian Name
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    Other assistance the Family receives (check all that apply)

    Certifications, Agreements, and Understands

    By submitting this application, you certify that: (must select all)(Required)
    By submitting this application, you agree to: (must select all)(Required)
    By submitting this application, you understand: (must select all)(Required)