National Sports Center for the Disabled - outdoor recreation opportunities for individuals with disabilities

Home

About Us

Winter Programs • Summer Recreation • Competition
NSCD Sports Camps • Soccer AbilityLEAGUE • NSCD-Kansas City • Sponsor An Athlete

Sponsor An Athlete

Very Important! Late or incomplete applications will not be considered. Please call 303-316-1544 or 970-726-1544 if you have questions regarding your inability to complete this form.

Athletes age 5 and older who demonstrate financial need may apply for a scholarship to participate in summer activities. Awarding full or partial scholarships is solely at the discretion of NSCD. Scholarship awards may be used for only one rafting lesson per season. Additional costs may apply for camps and overnight trips. Website submission of this application does not guarantee security of your personal information.

All portions of the application must be completed - do not leave any areas blank. Incomplete applications will not be accepted.

Scholarship Application – Winter 2010-11

Participant First Name: *

Participant Last Name: *

Age: *

Address: *

City: *

State: *

Zip Code: *

Daytime Phone: *

Evening Phone:

Email Address: *

If under age 18, guardian name:

Guardian Phone:

Participant’s Diagnosis: *

Place of employment (if under age 18, parent/guardian place of employment)

Work Phone:

Monthly household income and expense: *

Monthly Income:

Applicant

Parent/Guardian
If living in same household

Wages

SSDI

Other

TOTAL

Number of people in household: *

Number of people in household
under the age
of eighteen:

Select the option that best describes your current
living environment: *

Living with parents
Living independently/alone
Living with spouse
Living temporarily in a group facility
Living permanently in a group facility

Other (please describe):

Dollar amount
in monthly
bills (utilities, rent/mortgage, meals, medical, etc.): *

Have you participated previously at the National Sports Center for the Disabled? *

Yes
No

If yes, what activities

For how many years

Activity for which scholarship will be used (please select only one). *

Daily Activities:
Alpine Skiing	Snowboarding
Nordic Skiing	Ski Biking
Snowshoeing	Other

Camp:
Ski and Snowboard for Teens	Weekend Get-a-Way- For Families of People with Autism
Weekend Get-a-Way- Adults with Physical Disabilities	Winter Wonder Camp
Weekend Get-a-Way- Adults with Developmental Disabilities	Salute to Troops

Weekly Programs:
Friday Club	Thursday Access Ski and Snowboard Bus
Outrigger Club	Sunday Low Vision or Blindness Bus
Craig's Crew	Ski and Snowboard for Military Veterans

How much financial assistance would you need in order to attend? *

Do you plan to participate in NSCD programs with a group (through a hospital, school, parks and recreation department or other organization)? *

Yes
No

If yes, list name of organization

Address of organization

Organization contact

Contact’s phone

Please describe how you believe participating in NSCD programs will benefit you (i.e. meet new friends, improve physical condition, etc.)? *

Please provide any additional information the NSCD should consider when reviewing your application.

I have read and understand the Application Guidelines and Requirements of Scholarship Recipients. If I receive a Sponsor An Athlete Scholarship from the National Sports Center for the Disabled, I agree to those conditions. I understand that failure to comply with the requirements will result in being ineligible for a scholarship for the following year.

Agree: *

Yes
No

I have a family member or friend who would like to give back to the NSCD by volunteering his/her time. Please send me more information.

Yes
No

Participant Name: *

Applicant/Guardian Signature: *

Date: *

By checking this box, this will act as your digital signature. *

I agree

It is the policy of the National Sports Center for the Disabled to maintain a nondiscriminatory application process. The NSCD does not award scholarships based upon age, sex, race, color, religion, national origin, disability, sexual orientation, marital status or veteran status.

P.O. Box 1290, Winter Park, Colorado 80482 USA ph: 970.726.1540 or 303.316.1540 fx: 970.726.4112
Denver Office: 1801 Bryant St, Ste 1500, Denver, CO 80204 ph: 303.293.5711 fx: 303.293.5448 Email: info@nscd.org
KC Office: 4600 E. 63rd St, Kansas City, MO 64130 ph: 816.513.7571 Email: infokc@nscd.org

Home • About Us • Programs • Events • Donations & Sponsors • Volunteers • Media • Links & Resources • NSCD-KC