Please read the following Somerville Parks and Recreation Scholarship Program information. To apply for scholarship consideration, please fill out the application below.
GOAL
To make parks and recreation programs available and affordable for all citizens of the City of Somerville. Most recreation programs carry a registration fee to help offset program costs. The city offers parks and recreation scholarships to make recreation programs more affordable to low- and moderate-income residents.
ELIGIBILITY
The City of Somerville Parks and Recreation Department is solely responsible for determining the eligibility of an applicant based on the information provided by the applicant on the "Scholarship Application" form, and utilizing the
most current. Federal poverty level, 150%. In order to be considered for a scholarship, an applicant must submit a completed
application form.
Restrictions
All scholarship participants missing 25% of a class with an unexcused absence, more than twice, will be in violation of the scholarship policy, and will be taken off scholarship status immediately. If the applicant finds they cannot regularly attend a class, it is their responsibility to contact the Program Developer to discuss the matter. The City of Somerville reserves the right to review past usage of the scholarship program to determine if a household is eligible for the program based on attendance and their compliance with the policies associated with the scholarship program.
All registrants must be approved for the scholarship program in advance of a class or activity in order to receive scholarship benefits. Anyone registering or attending a class prior to scholarship approval will not be issued a refund or
credit based on scholarship rates. All participants must be registered into a class with payment submitted prior to the start date of a class or activity.
Important Information
Due to the large number of participants in programs, please plan ahead to have application and income verification compiled to help reduce the approval waiting period. Listed on the scholarship application is a checklist to use in making sure all the required information is submitted.
Please plan ahead — have your scholarship approved in advance of activities because there will be no guarantee your
application will be processed before the beginning of a registration deadline. Scholarships will be processed within 10 working days. Scholarship applications must be turned in at least two weeks prior to the registration deadline of a class.
*** Please note: Scholarship applications are only reviewed quarterly per calendar year per applicant ***
Name
Home Phone:
Work Phone:
Email Address:
Street:
City:
Zip:
Including yourself, how many persons make up your household?
Family Composition:
Name: Relationship: Female/Male: Birthdate:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Are your children receiving Free/Reduced lunch? Yes No
Please provide the following information for ALL members of your household who have INCOME.
Income Section Must Be Completed and Signed Before Scholarship Can Be Processed. Proof of income required.
Name: Source of Income (see above):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Certification:
I do hereby acknowledge that the information I have provided above is true and accurate and that this information is subject to verification by the agency providing funding for this project. I also acknowledge that the submission of false or inaccurate information could lead to my removal from the scholarship program for a designated time.
Signature: _____________________________Date:______________________
What Programs are you interested in receiving a scholarship for?
What are the Program Dates/Sessions?
This information will remain anonymous and separate from other forms.
To help serve the community of Somerville better please fill out when registering.
How many people are in your household? Place a number next to your ethnicity.
Black/ African-American # Cape Verdean #
American Indian/ Alaskan Native # Latin American #
South American #
Hispanic #
Asian/ Pacific Islander # White#
Central American #
Other: # #
Parent Name (Initial only your First name, Last Name e. GJ) ______________