Application

I am interested in:(Required)

Give 'Em the Ball

Just Keep Playing

Name(Required)

First Last

Phone(Required)

Email(Required)

Are you current receiving some form of social assistance?(Required)

Yes

Such as: TANF, SNAP, D-SNAP, WIC, CHIP, Disability, HUD, or emergency/temporary housing

If yes, would you be willing to meet us in person to provide proof of the assistance you are receiving?

Yes

This is to verify that you are receiving assistance and qualify you for the program. We will not photograph, save/log your data, but we do need to verify your participation.

Name of athlete(s) needing assistance(Required)

What Sport and Season will assistance be needed?(Required)

Does the athlete need equipment? If so, what is needed and why?(Required)

What is the dollar ($) amount required to meet this assistance?(Required)

We are sorry. This program is available to participants who are currently receiving some form of assistance.

Court Name / Location(Required)

Tell us any related information about the gym

Comments

This field is for validation purposes and should be left unchanged.