2020/21 Midwest United FC Player Assistance Application
Please carefully read all of this information. As you fill out this form, you are required to answer all questions. If a question does not apply to your situation, please type "none" in the open space. If you have more than one player, you only need to complete this form once for your family.
Make sure to check the box at the end of the form to have your completed form emailed back to you. Save this email!! If something happens to your application, it is proof you applied. If you don't get an email back we do not have your application. You then must contact us BEFORE the deadline otherwise you will not receive assistance.
The deadline for application is:
November 15, 2020
***NO LATE applications will be accepted.
Completion of this application DOES NOT GUARANTEE an award of financial assistance. All applications will be given full consideration.
You will be notified of your assistance amount by email. If you do not hear from us by November 23, please contact: email@example.com
PLAYER'S Last Name
PLAYER'S First Name
PLAYER'S Birth Date
PLAYER'S Age Group
Please select the age group that applies for the 20/21 season.
# of Players at Midwest United
Please select how many players you have
Other Players / Teams
Please enter their first and last name, age and team
Do you have children playing in other clubs
Please name the other clubs
Please enter the total amount in dollars you are requesting in financial assistance. (For example, $250. Do not say 50% or anything appreciated.)
***This is NOT the guaranteed award amount.
Parent 1 / Guardian 1 First and Last Name
Is this your first time applying for Midwest United FC player assistance?
Street Address 1
Other State 1
Home Phone 1
Type none if you do not have a landline.
Cell Number 1
Employment Status Parent 1
Please enter the status of your employment
Please select your preferred method of contact.
Parent 2 / Guardian 2 First and Last Name
Employment Status Parent 2
Please enter the status of parent 2's employment
Parent 2 address
Does Parent 2 have a different address?
Street Address 2
Other State 2
Cell Number 2
Do you rent or own your home?
Value of Home
Please state the estimated value of your home
Please enter the balance of your mortgage
Please select all that apply
Please list any additional expenses (such as college tuition or private school payments) and designate who they are for
Total number of people living in home
Does your family receive financial assistance?
Name of Agency
Has COVID-19 impacted your financial situation?
Impact of COVID-19
Please state how your family has been impacted.
*Was your employment status changed due to COVID-19
* Will you return to your job
Please use this section to provide any further information that you would like us to consider when determining financial assistance (employment status, unexpected hardships, etc)
Please explain any extenuating circumstances that have impacted your financial situation short or long term.
Terms of Agreement
I certify that all of the above information is true and correct. I understand that this information is being provided as a method to assist Midwest United FC staff in staff in determining the level of financial assistance that may be awarded toward player fees.
I understand that monies provided through this application process will be used to pay player costs, and will not pay for any supplemental expenses associated with participating in Midwest United FC (travel expenses, team fees, uniform, etc.).
I authorize the representatives of Midwest United FC to discuss this request with the team manager/coach, along with board members in an effort to make a determination of what financial assistance may be granted and/or track payments against an established payment plan.
Acknowledgement of Terms
Please enter your initials
Tax Form Submission
For consideration, all applicants must supply a copy of their most current annual Federal Tax form 1040A. If parent 1 and parent 2 file, separately attach both returns. Blackout all social security numbers on the forms for your privacy.
Separate Tax Filing
***NOTE: Two separate applications are needed if parent 1 and parent 2 split the responsibility for the player fees and they both wish to be considered for aid.
An example might be if divorced parents split the bill and each play half. If one applies the award will be for only their portion of the bill unless both apply.
Additional Tax forms
Also attach supporting tax schedules if you have income from:
Business (Schedule C or C-EZ and Form 4562)
Farm (Schedule F and Form 4562)
Rental Property (Schedule E)
S-Corporation (Schedule E, Form 1120S, Schedule K-1 and Form 8825)
Partnership (Schedule E, Form 1065, Schedule K-1, and Form 8825)
Estates and Trusts ( Schedule E, Form 1041, Schedule K-1)
All information submitted will be kept confidential. Midwest United FC is prohibited from discriminating on the basis of race, color, national origin, or sex.
Please use the next section to upload your required documents. You can upload multiple forms with the link.
Agreement to Terms of Form
**I understand that if I do not include all requested information this application WILL NOT be considered.
Please enter your FULL LEGAL name
Please enter today's date
Add to Contact List
Would you like to be contacted about future volunteer opportunities with Midwest United? This will add your email address to the list we use when the club is looking for help with a wide variety of events and activities.
Send me a copy of my responses
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