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To all players registered with the Chappaqua Youth Soccer Club (CYSC):
 
Financial aid is available if you need assistance with the monetary commitment to playing on one of the CYSC teams. The application should be mailed to me by September 15, 2010

Click here to download the financial aid application




ALL INFORMATION WILL REMAIN CONFIDENTIAL
 
CHAPPAQUA YOUTH SOCCER CLUB
 
FINANCIAL AID APPLICATION FORM  ( 2010-2011) ENYYSA/USYSA
Financial aid is available from CHAPPAQUA YOUTH SOCCER CLUB (“CYSC”) in cases where a family might otherwise have difficulty paying for travel team costs.  The process for applying is simple.  You may qualify based on either a) household income or b) other circumstance such as loss of job, et al.
 
NOTE: Financial aid will not cover optional CYSC programs such as the preseason camp or indoor winter training or winter tournaments.  Those expenses will be the responsibility of the player if they elect to participate.
 
A) To qualify under the household income provision, please certify as follows:
I have household income equal to or less than: 
– $40,000 for a single person 
– $50,000 for a family of two 
– $60,000 for a family of three 
– $70,000 for a family of four 
– $80,000 for a family of five 
B) To qualify under “other circumstance”, please explain______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
 
 
Name of Player(s): Telephone (Res):
Address: Telephone (Bus):
City/State/Zip:
 
Date of Birth of Player(s):  (Month / Day / Year)  ___/___/___
 
TEAM NAME(S):   __________________________________
 
TEAM DIVISION (please check the appropriate boxes):
 
Boys U10 U11 U12  U13  U14  HS
Girls U10 U11 U12  U13  U14  HS
_____________________________________________________________________________________________
 
I certify that the information on this application form is accurate and complete. I understand and agree 
that the CYSC may contact me in the future to verify this information or request additional information in order to determine or confirm eligibility. I understand that a subcommittee of the Board of Directors of the CYSC will review my application, determine my eligibility, and notify me based on the information I provide. I further understand that there are no assurances or guarantees that financial aid will be extended and agree and release and hold harmless CYSC and its Board of Directors in the event that such financial aid is not extended.
 
Signature: Date:
 
MAIL TO: 
            CYSC, c/o Dan Kreisler, 26 Crestview Dr, Pleasantville, NY 10570