EmailMe Form - Scholarship Application

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All information is kept confidential.

Please note that the amount of scholarship financial assistance is limited. Scholarships are not automatically renewed and an application must be filled out for each sport. Approved scholarship receipients may receive a reduced fee OR deferred payment deadline for the sport which they have registered for. As part of our scholarship program, HRA respectfully asks all our scholarship families to volunteer to the extent possible. We encourage you to contact HRA at info@highlandrecreation.org for volunteer opportunities. Thank you in advance for your support and understanding. PLEASE ALLOW UP TO 72 HOURS FOR APPLICATION REVIEW

Your Name: *

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Home Phone *

### - ### - ####

Work Phone

### - ### - ####

Cell Phone

### - ### - ####

Email Address *

Name of child you are seeking scholarship assistance for: *

Childs Date of Birth *

MM / DD / YYYY

Child's Grade Level *

(For Pre-K use 0)

Sport you are seeking assistance for: *

Your Occupation *

Please provide a brief explanation of why assistance is needed at this time OR time extension needed to submit payment *

I understand that completion and submission of this form does not constitute approval of a reduced fee or deadline extension and will only be available upon review and processing of this application by the Highland Recreation Association Board. *

I Agree & Acknowledge

(Please allow up to 72 hours for review of your application - Thank you.)

PLEASE TURN OFF POP-UP BLOCKER BEFORE COMPLETING THIS FORM *All information is kept confidential.*

PLEASE TURN OFF POP-UP BLOCKER BEFORE COMPLETING THIS FORM

All information is kept confidential.