Youth Scholarship Form

A Fargo Park District Program for Income Assistance Use a separate form for each participant for each program. Additional forms are available in our office or FargoParks.com

The Fargo Park District strives toward serving the needs of all citizens regardless of income level. To achieve this, it is necessary to establish a department policy. The Fargo Park District’s approach toward serving the low and moderate income citizens of the City of Fargo shall be:

OBJECTIVE

To provide opportunity to allow financially disadvantaged youth ages 18 and younger to participate in general recreation programs.

POLICY STATEMENT

It is the policy of the Fargo Park District that no individual 18 years and younger that is a current resident of the City of Fargo for at least 90 days and lives within the corporate limits of the City of Fargo, shall be denied participation in general recreation programs due to financial inability to pay the program fees.

INCOME ELIGIBILITY GUIDELINES AND PHILOSOPHY

• To be eligible for this program, the Fargo Park District must receive a completed scholarship application, income verification AND a program registration form prior to registration deadline. • Eligibility will follow the federal lunch assistance program guidelines. Each child may be eligible to receive one per season. • Must be a Fargo resident to apply for this scholarship.

Additional applications are available online at FargoParks.com or in our offices at 701 Main Avenue.

Programs available for income assistance for Youth Programs are: • Adaptive Programs (1/2 of fee) • Archery • Baseball/Softball • Basketball • Fencing • Figure Skating Lessons • Flag Football • Golf Lessons (one session) • Hockey Skills • Outdoor Season Pool Pass (No Registration Form Required) • Playtown (1/2 of fee) • Sports Sampler • Swimming Lessons (one session) • Track & Field • Volleyball (1/2 of fee) • Volleyball Camp (1/2 of fee)

One form per child. REGISTRATION FORMS FOR DESIRED PROGRAMS MUST BE ATTACHED TO THIS APPLICATION IN ORDER TO QUALIFY. ABSOLUTELY NO EXCEPTIONS!

Submit one of the following for income verification along with a current drivers license. If one of these is not submitted, your application will not be processed.

1. Most recent Federal Tax Return or 2. SNAP “Review Approved” letter or TANF approval letter

Child’s Name:________________________________________________________ Birth Date:_______________ Gender: ( M / F )

Address:________________________________________ City:______________________ State:_________ ZIP:_______________

Daytime Phone #:_______________________________________ Home Phone #: _______________________________________

E-mail Address:_________________________________________ Parent/Guardian Name:________________________________

Program Name(s) choose from list above:_________________________________________________________________________

Mail or drop off: Fargo Park District, Attn: Scholarships, 701 Main Avenue, Fargo, ND 58103

FOR OFFICE USE ONLY SNAP or TANF Case #______________ Tax Return Year________ Gross Wages______________ Dependents_____________