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.

Player Information

Click "Add Entry" to add a player

Player Name	Date of Birth	Actions

There are no Entries.

Parent/Guardian Name

First Last

Parent/Guardian Email

Parent/Guardian Phone

Enter the Gross Annual Family Income on most recent tax return

Upload your most recent tax return.

Drop files here or

Accepted file types: pdf, jpg, png, Max. file size: 256 MB.

Other assistance the Family receives (check all that apply)

Reason for seeing assistance. Please explain why you are seeking financial assistance. Please include any information that you feel would be helpful to the Financial Assistance Committee.

Certifications, Agreements, and Understands

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

All the information on this application is true and correct

All players in the household are in good standing with the club

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

Provide your federal income tax return to verify income and household size.

Provide proof of eligibility for free or reduced lunch if requested.

Provide additional information and documentation to determine eligibility if requested.

A one-year financial commitment to the club. If your player should leave the club before fulfilling this commitment, you shall be required to meet whatever financial obligation remains.

Ensure your player(s) will participate in at least 80% of scheduled practices and games.

Donate service to the club (e.g. help with fundraising, concession stand, club day, holiday parade, sponsorship solicitations, etc to help offset the costs to the club).

Payback any or all of the fee reduction received if you are able to help ensure the club can provide assistance to others in need.

By submitting this application, you understand: (must select all)(Required)

Assistance is not guaranteed.

Assistance applies to registration, coaching, and club fees only.

Assistance does not apply to expenses for uniforms, tournaments, special fee-based camps/academies/personalized training sessions, travel, etc.

Assistance is granted annually and a new application must be submitted by AUGUST 31st for the upcoming season. Applications may be considered after the due date based on availability of funds on a first-come-first-serve basis.

All personal data submitted is strictly confidential and shall be destroyed or returned after assessment of need. Personal data shall only be available to those club officials with a need-to-know.

The Executive Board reserves the right to cancel any financial assistance arrangement at any time by a majority vote.