Van Meter Parks & Recreation Financial Aid Application VMPR Youth Sport Financial Assistance Application Youth Sport Participant Information Name * First Last * Last Participant Age * Participant Date of Birth * Participant Grade * Participant Address * Please select the applicable sport for the above mentioned participant. * Spring SoccerFall SoccerLittle League BaseballYouth Rec SoftballFlag FootballYouth Tackle FootballYouth Rec Basketball End Section Next → Applicant (Legal Guardian) Details Legal Guardian #1 Name * Legal Guardian #1 Name First Name First Name Last Name Last Name Legal Guardian #2 Name Legal Guardian #2 Name First Name First Name Last Name Last Name Legal Guardian #1 Phone Number * Legal Guardian #2 Phone Number Legal Guardian #1 Email * Legal Guardian #2 Email Number of Residents in Household * Legal Guardian Address * Proof of Income Eligibility * ONE of the following documents is required to provide proof of income: Front Page of most recent Federal 1040 Personal Income Tax Return, Two consecutive pay check stubs (most recent), Social Security Income Benefit Statement, Unemployment Benefit Statement , Disability Income Benefit Statement OR Public Assistance Income Benefit Statement End Section Next → Youth Sports Financial Aid Request If you are requesting financial assistance for circumstances other than income based, please describe your request below or upload your request. Please attach as a .pdf file. Please provide any additional information that supports your request. Have you previously received a need based financial award from Van Meter Parks & Recreation? * Yes No If so, when? End Section Next → Certification The information provided in this application shall be kept confidential and will not be shared with anyone else. Certification * I certify that the information here is true and correct Applicant (Legal Guardian) Name * Date * End Section Captcha Submit
