Stein Eriksen Dare To Dream Application Apply for YSA Stein Eriksen “Dare to Dream” Scholarship Online SPRING YSA Stein Eriksen Endowment Scholarship Application Date* MM slash DD slash YYYY Important InformationThe purpose of the YSA Stein Eriksen Dare to Dream Scholarship program is to provide financial assistance to deserving athletes enrolled in Youth Sports Alliance member programs who cannot participate or compete without the help of scholarship funding. Funds for the scholarships are provided by the Stein Eriksen YSA Opportunity Endowment and scholarship donations raised through JANS Winter Welcome, an annual fundraising dinner.*Before completing your application, please read the following: Scholarship Criteria Document I have read the YSA Stein Eriksen Endowment Dare to Dream Scholarship Criteria and confirm I meet all requirements. I acknowledge that all required documents for this application must be received by YSA during the application period. Late or incomplete applications may not be eligible for scholarship. Spring Funding Information: Please read thoroughly*Spring Application Period: Spring scholarships will be used for unexpected competitions (those which athlete qualified for throughout the season such as post-season Junior Nationals and Junior World Cups) and invitational camps. Camps and competitions must be sanctioned by governing body and not privately owned. I understand spring scholarship funding will cover only additional competitions and camps - those for which the athlete qualified during the season and were NOT part of the fall scholarship request. I understand scholarships will only be given for camps and competitions sanctioned by the governing body and will not fund private camps. Applicant InformationYSA does not discriminate on the basis of religion, race, color, sex, ancestry, sexual orientation, disability, national origin, or any other protected category in accordance with applicable federal, state and local laws.Applicant First Name* Applicant Last Name* Date of Birth* MM slash DD slash YYYY Age*Please read age requirements in Scholarship Criteria Applicant's Email* Applicant's Phone*Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please make sure this is a valid mailing address.Parent/Guardian First Name* Parent/Guardian Last Name* Parent or Guardian's Email*If applicant is under 18 years of age, parent/guardian's email provided will be used for all communication Parent/Guardian Phone Number*Relationship to Applicant* Mother Father Legal Guardian Team Name*Please select oneFigure Skating Club of Park CityPark City Ice MinersPark City Ski and Snowboard - Alpine DivisionPark City Ski and Snowboard - Freeski DivisionPark City Ski and Snowboard - Freestyle MogulsPark City Ski and Snowboard - Freestyle AerialsPark City Ski and Snowboard - Nordic DivisionPark City Ski and Snowboard - Ski Mountaineering DivisionPark City Ski and Snowboard - Snowboard DivisionPark City Speed Skating ClubWasatch Luge ClubWasatch FreestyleUOP Bobsled and Skeleton ClubDiscipline* Current Level* Years with Team* Coach's Name* Applicant's School*Ecker Hill Middle SchoolTreasure Mountain Jr. HighPark City High SchoolJeremy Ranch ElementaryMcPolin ElementaryParleys Park ElementaryTrailside ElementaryWinter Sports SchoolPark City Day SchoolOtherSchool - OtherIf you selected "other" in the question above, please list the school you attend. If you were able to select school from list above, skip this question. Applicant's GPAPlease indicate overall GPA range below, if applicable.4.0 and above3.75-3.993.5-3.743.0-3.492.5-2.992.5 and belowIf applicant is a member of a National Team please list name of team here: YSA encourages multisport participation. If applicant participates in other sports, please list here: Cost and Funding InformationPlease list Name of competitions, locations, and dates for which you are applying for funding:Cost of Competitions & TravelPlease estimate competition fees and estimated travel expenses for each competition. Applicant must have qualified for these competitions throughout season and the expense must not have been part of the fall funding requested amount.Funding Request for Competitions & TravelAmount applicant is requesting to aid in cost of competitions and travel.Please list camps , if any, applicant qualified for during the season for which you are applying for funding:Applicant must have qualified for these camps throughout season and the expense must not have been part of the fall funding requested amount. Please remember Elite Camp qualification varies sport to sport. Refer to the Scholarship Criteria Document for camps that are eligible for scholarship.Cost of CampsCost of camps approved by YSA Scholarship Criteria. Applicant must have qualified for camp throughout season and was not part of the fall funding requested amount.Funding Request for CampsAmount of funding you are requesting to aid in the cost of camps. Applicant must have qualified for camp throughout season and was not part of the fall funding requested amount.TOTAL COSTS*Please include costs for competitions, travel, and camps that your family will incur. This should be the total from the above "cost" questions.TOTAL FUNDING REQUESTED*This is your total scholarship funding request. Please include requested amounts for competitions, travel, and camps. This should be the total from the above Funding Request questions.How much funding has applicant received from YSA Stein Eriksen Opportunity Endowment?*Please indicate the total funding athlete has ever received from YSA in the past.$0$1-$500$500 - $1000$1000 - $2000$2000 - $3000$4000 - $5000$5000 - $7500over $7500Is applicant expecting funding from other sources this year?* Yes No If you answered "yes" from above question, list the sources of funding and amounts.Funding from other sources will not affect the determination of YSA scholarship amount. Does the applicant participate in the Free and Reduced Lunch Program?* Yes No Required DocumentationEach applicant is required to provide specific documentation regarding financial need, including but not limited to the past two years' tax returns. If applicant is part of a multi-household family, tax returns must be provided for all households (all financial supporters), even if applicant is over 18 years of age and submits an individual tax return. Tax Documents: Past 2 years tax form 1040 (first 2 pages only)*Upload here: Drop files here or Select files Accepted file types: jpg, pdf, Max. file size: 128 MB. Additional Information hereIf applicable, upload any additional information that will help the Scholarship Committee better understand your financial need. Drop files here or Select files Accepted file types: jp, pdf, doc, docx, xls, csv, xlsx, txt, Max. file size: 128 MB. Camp InvitationIf applicable, upload your Invitation to the Post Season camp in which you qualified for here. Drop files here or Select files Accepted file types: jp, pdf, doc, docx, xls, csv, xlsx, txt, jpg, Max. file size: 128 MB. Applicant LetterApplicant must provide a letter with the following information: a) Why should you be considered for the YSA Stein Eriksen Dare to Dream Scholarship? b) What are your goals in your sport program? c) How does this program affect your life? d) Read the YSA Core Values and explain what these values mean to you and your future. e) Include any personal financial contributions to your sport such as employment, personal fundraising, etc. f) Add any additional information that might be helpful in evaluating your application. Drop files here or Select files Accepted file types: jpg, pdf, doc, docx, xls, csv, xlsx, txt, Max. file size: 128 MB. Coach's Recommendation FormNotify your program director or coach of your application well in advance of the deadline and ask him/her to complete the Coach's Recommendation Form on your behalf. The coach has access to this form on our website , it will be sent directly to YSA. This form will remain confidential. I understand it is my responsibility to have the Coach's Recommendation Form completed and received by YSA prior to the application deadline. I understand the Coach's Recommendation Form is confidential between the coach and YSA. End of Season Scholarship Recipient Report*YSA End of Season Report I acknowledge that if I receive a YSA scholarship it is my responsibility to complete the End of Season Report on the YSA website. Future funding may be dependent on completion of this requirement. Thank You Letters*Our donors love to hear from you! Please write two Thank You Cards, addressed to "Dear YSA Donor" and mail to YSA at PO Box 681698 Park City, Utah 84068 I acknowledge that if I receive a YSA scholarship it is my responsibility to complete two Thank You cards. Future funding is be dependant on completion of this requirement. YSA Privacy Policy*YSA Privacy Policy I have read and accept the YSA Privacy Policy I authorize YSA to use my name for marketing, granting, and public relation purposes. Funding will not be affected by my preference.* Yes No I would like to represent YSA at public events such as fundraisers, radio and/or T.V. Funding will not be affected by my preference. Funding will not be affected by my preference.* Yes No Consent*To the best of my knowledge, I hearby certify that all documentation I provided is accurate, complete, and true Applicant ApprovalApplicant Electronic Signature*Type your name here acknowledging the statement above. Consent*To the best of my knowledge, I hearby certify that all documentation I provided is accurate, complete, and true Parent/Guardian ApprovalParent Electronic Signature*Type Parent/Guardian name here acknowleging the statement above. FileMax. file size: 128 MB. Δ
