Scholarship Application

The City of North Port Parks & Recreation is thankful for the generous support from donors for the Youth Scholarship program. This program provides qualifying North Port residents age 17 and under scholarships to participate in two (2) recreation or aquatic programs for the Winter/Spring and the Summer/Fall seasons, and/or two (2) weeks of summer camp per year. To qualify the applicant must meet the following criteria: 1. The child's household must have a yearly gross income that is at or below 100% poverty based on the most recent poverty guidelines published in the Federal Register by the U.S. Department of Health and Human Services. 2. The child's parent or guardian must provide current proof of North Port residency. 3. The child must be 17 or younger. Scholarships will be granted on a first-come, first-served basis, as funding is available. Please complete the form below and attach supporting documents. If you have any questions or need further assistance please call 941-429-PARK (7275).

Parent/Guardian Last Name*

Parent/Guardian First Name*

Parent/Guardian Phone*

Parent/Guardian Email*

Child's First Name*

Child's Last Name*

Child's Birthdate*

Child's Address*

Number of Adults in the Child's Household*

Please provide the total number of adults that live in the same household as the child that is applying for a scholarship.

Total Number of Children in the Child's Household*

Please provide the total number of adults that live in the same household as the child that is applying for a scholarship.

Address Verification*

Please attach address verification using the link at the bottom of this form. Please select the form provided here:

Other Form of Address Verification

If you selected "Other" in the previous question - please provide information on what address verification is being provided.

Income Verification*

Please provide verification that the child's household income is at or below 150% of the most recent poverty guidelines from the U.S. Department of Health and Human Services

Florida Access / Food Stamp Award Letter (Current)

WIC Award Letter (Current)

Social Security Disability Award Letter (Current)

Unemployment Award (Current)

Other

Other Form of Income Verification

If you selected "Other" in the previous question - please provide information on what income verification is being provided.

Tax Return

Pay stub (within last 30 days)

What Program is requested?*

What program will the qualify child like to be enrolled in?

File Upload*

Please attach: 1. Residency verification. 2. Income verification

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