Belvedere Cove Foundation

THE BELVEDERE COVE FOUNDATION
P.O. BOX 786 BELVEDERE, CA 94920
ON LINE SCHOLARSHIP APPLICATION FOR PARTICIPATION
IN YOUTH SAILING PROGRAMS

A limited number of scholarships are available to youth wishing to participate in youth sailing programs. If scholarships are being requested for more than one sailor from the same family please complete one scholarship form for each applicant. Recipients will be asked to pay for a portion of the program fees and their families will be asked to complete volunteer hours for the program for which the funds are requested. The parent/guardian and sailor will be contacted for an interview as part of the evaluation process. If you have any questions, please email Laurel Holm (laurel.holm@belvederecove.org), Scholarship Chair.

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APPLICANT SECTION:

Date of Application:

Name if Applicant (First/Last)
Street Address
City State Zip Code
Phone Fax

E-mail (Required)

Age Date of Birth

Grade School

PROGRAM SECTION:

Name of program for which funds are requested:

Street Address
City State Zip Code
Phone Fax

E-mail

Date(s)of the program

Briefly describe program:

Person in charge

FUNDING SECTION:

Cost of program:

Personal funds to be used:

Funds requested from The Belvedere Cove Foundation

Are you requesting funds from other source(s)? If yes, please name the source(s) and give amount(s).

PARENT/GUARDIAN SECTION:

Name of Parent/Guardian (First/Last)
Street Address
City State Zip Code
Phone Fax

E-mail

In the following section the applicant shall write a short statement as to why he or she wishes to participate in the youth sailing program for which funds are requested. Also, the parent or guardian is asked to provide information that will also be helpful in the evaluation process. This information will be considered confidential.

Applicant's Name:

PARENT/GUARDIAN'S MONTHLY INCOME:

Gross Wages

Net Wages (after mandatory and other debt payments)

Other income (child support, alimony, dividends, interest, etc.)

PARENT/GUARDIAN'S MONTHLY EXPENSES:

Housing

Food/Clothing

Legal obligations (child support, alimony, etc.)

Monthly consumer debt payments (credit cards,car, etc.)

EMPLOYER:

Name
Street Address
City State Zip Code

Names of other children:

APPLICANT'S STATEMENT:

"Why I want to participate in the Youth Sailing Program."

PARENTAL STATEMENT:

Please provide below any information or reasons you feel are relevant to this application including spousal status and special existing demands on available income. THIS INFORMATION WILL REMAIN CONFIDENTIAL.

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The Belvedere Cove Foundation

P.O. Box 786, Belvedere, Ca. 94920

(415) 273-1510