No Footballer Left Behind Foundation-Grant Application

GRANT ALLOCATIONS FOR AUGUST 10, 2013

Note this form must be turned in to your Club DOC by August 5, 2013.

Club Circle one: WSA TSCH Blitz NEOFC BIXBY HIGHLANDERS Tulsa Nationals FT. GIBSON

(These are the only clubs participating at this time, if your club is not on the list please ask them to join our foundation)

Player Name______Team______

Email______Phone______

Team Manager______Coach______

Players Full Address______

# of adults living in home______# of Children in home______House # of Bedrooms______Baths______Approx Sq Feet______Monthly Gross (before taxes) Household income(all adults living in home) $______ List all automobiles; year, make and Model in home ______

Does player receive reduced or free lunch at school? Yes No

Does Family receive Food Stamps? Yes No

Team Manager to fill out this section below:

This year’s expenses for player: Scholarship Club Dues $______Tournament Dues $______League Dues $______Travel Expenses, $25 per day food $______Hotel % $______Uniform, only if new one is required this year $______Other List______$______Total $______

No Footballer Left Behind Foundation offers need based grants to soccer players from participating clubs. Each club is responsible to award full, or partial, grants based on players need. All applications received by the club should be kept on file and made available to the foundation if questions arise. All monies are to be paid directly to the team account and used exclusively for the player who was awarded the grant. If that player, for any reason does not continue with your team, or doesn’t use all of the funds allocated, the money is to be returned to your club and reallocated to another qualified player. By accepting this grant the team manager and coach agree to participate in next year’s NFLBF tournament and exhibition game. Player and/or players family agrees to volunteer at the event. Please help make the soccer community aware of our foundation.

Parent/ Guardian Name______Phone #______

Parent Signature______Players Signature______

Manager Signature______Date______

Coach’s Signature______Date______

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The soccer club circled above certifies this player has been qualified as one of the clubs neediest players and will allocate monies to this player’s team to help pay for his/her annual costs to play soccer. The amount we are allocating to this player is $______