Everyone's A Player
Providing Sports Opportunities
for Youth in the Merrimack Valley and Lowell
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EAP Application Form
To be completed by a parent or guardian
Child's Name:
*
Parent/Guardian Name(s):
*
Address:
Town:
*
Home Phone:
Cell Phone:
Email Address:
*
School:
Grade:
Date of Birth:
*
Child's Age:
List Current Sports and/or After School Activities:
What Sport are You Applying For Funding:
Reason for Need of Assistance:
*
How Many Family Members in Household:
Does your Family Qualify for Free or Reduced Lunch Under the National School Lunch Program? Yes or No
*
Household Income:
$0-$29,000
$30,000-$59,000
$60,000-$89,000
$90,000 or more