Your Email (required)

Subject

Current Season

Scholarship Type

Age Group

Player Name | Parent Name | Player Address| Parent Address if different

Telephone #

Scholarship Reason:

Are you receiving Federal assistance? WIC Card # :

Times available to volunteer:

Information is for the sole purpose of helping CCSA Board determine who the most needy families are for a particular season. There are a limited number of scholarships avaiable per season. Partial scholarships will cover 50% of the total cost of registration. *Recipients of scholarships will be expected to volunteer their time in exchange for their scholarship.

These requests are strictly confidential and will not be shared with anyone other than the President, Vice President & Treasurer of CCSA.