Scholarship Application Please fill out the information below. Thank you. Name of Student First Last Phone Number Name of Parent/Guardian (if applicable) Address County Are you a student? Yes No Where? Program/Lesson Dates You are Requesting Employer Employer’s Address Estimate of Need: Lesson prices subject to change. Please phone adaptive sports for current pricing. Current lesson prices $225.00 per day child, $275.00 per day adult.Total fee(s) for the program dates requested. Maximum Amount You Can Provide Toward Tuition Minimum Amount You Need in Financial Aid Please answer the following questions:Have you received a scholarship in the past? If so, how many times? Do you currently receive government assistance? Yes No If so, please describe. Are you a member of a subsidized living program? Yes No Which program? What is you or your family’s annual income? Are you supporting other persons besides yourself? Yes No Who are you supporting (family/spouse, number of children)?Briefly describe why you are seeking a scholarship with SAAS.Signature Δ
