Your Name *

Your Email *

Player Information

Players Full name *

Date of birth *

Age *

Grade *

School *

Parent/Guardian Name *

Contact Phone

Household Financial Information

Are you on any Public assistance? *

SNAP (food stamps), TANF (cash assistance), Medicaid and CHIP (health coverage)

Does your family qualify for free/reduced school lunch programs? *

Brief explanation of financial need (if applicable): *

Mandatory Volunteering Requirement

As part of the VCYFA scholarship program, recipients are required to participate in a minimum of 10 hours of volunteer service with VCYFA. This requirement helps foster a sense of community and teamwork among our scholarship recipients. *

Volunteer Service Plan

If selected, please choose one or more of the following volunteer opportunities to fulfill your requirement:

If selected, please choose one or more of the following volunteer opportunities to fulfill your requirement: *

Requested Assistance

Requested Assistance *

Payment Plan (split fees into installments):

Initial Deposit: $______ (minimum $5 required to secure spot)

Remaining Balance: $______

Final Payment Due By: July 31st/Uniform Delivery

Terms & Conditions

Scholarships do not cover travel or additional fees. *

Payment plan defaults may result in withheld eligibility. *

Volunteer hours not completed may affect future scholarship eligibility. *

Attachments Required *

I understand

Proof of free/reduced lunch status (if applicable). Additional hardship documentation (e.g., Medicaid/SNAP verification). (if applicable).

Contact Us

If you have any questions or need further assistance, please do not hesitate to contact us at: Vigocountyyouthfootball@gmail.com

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