SCHOLARSHIP REQUEST 
(To be turned into the league office or with the team roster)


Parent/Guardian Name _________________________________________________________________

Name of Child________________________________________________________________________ 

Address ___________________________________________________________________________ 

City _______________________________________ State ____________ Zip ____________ 

Home Phone _______________________________ Work Number __________________________ 

Managers Name _____________________________ 

Grade ____________________________________ Grade School Area _______________________ 

School Attending: __________________________________________________ 

Amount of Scholarship Requested:     25%____    50%____    75%____
(percentage or appropriate individual fee) 

Amount of Fee Able to Pay _______________ (must be attached to scholarship request) 

Reason for Request (please explain in detail) 
_____________________________________________________________________ 

_____________________________________________________________________ 

_____________________________________________________________________ 

____________________________________     _________________________ 
Parent/Guardian Signature                       Date
                   


__________________________________________________________________________________

                              
                         EJRT OFFICE USE ONLY

           Approved   ______________________  Not Approved _______________________
                                      (circle one) 
                                
                                  ____________________________ 
                                         EJRT OFFICER