Youth Scholarships OLD

Financial Assistance Confidential Application Form

What Parks and Community Services Department program are you requesting funding for? Please indicate Activity Number and Name of Class.
Activity Number   Class Name 
Fee for Class       Start Date of Activity 

Amount of funding requested $ 

Participant’s Name:   Age: 

Address: 

Primary Parent/Guardian Name: 

Primary Phone:  Secondary Phone: 

Email:

 

Family Size: 

 

Proof of one of the following programs (please check box(s) that apply):
 Medicaid
 WIC (Women, Infants, and Children)
 Free/Reduced Price School Meals
 Foster Care Participant
 Native American Tribe

Has your child received San Ramon Parks & Community Services scholarship funding before?     Yes   No
If Yes, When:     Amount $ 

Comments or additional information you wish to add:

 

I certify that all statements on this application are true and correct. I understand that false or incorrect statements shall be sufficient cause for disqualification of request.

Signatur​e 



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youth scholarship

YOUTH SCHOLARHSHIP PROGRAM
APPLICATION GUIDELINES & INFORMATION

The City of San Ramon Parks & Community Services Department, with support from RaSi Holds Hands and generous customer donations, have developed a scholarship program for San Ramon residents under 18 years of age. San Ramon residents who meet the qualifications and income requirements, as well as contribute a minimum of 25% towards each registration fee are eligible to apply.  All applications must be submitted in advance at least two (2) weeks prior to the start of the program. The Youth Scholarship Program provides a maximum of $300 funding per individual per fiscal year. (July – June). Funds are limited and subject to availability.

 

Step 1: See Whether You Qualify: Please review the eligibility criteria and instructions below for participation.

Eligibility Criteria:

In order to qualify for the Youth Scholarship Program, the participants are REQUIRED to provide copies of the following:

  • Proof of residency - Copy of utility bill.
  • Proof of enrollment in one of the following programs:
    • Medicaid/Medi-Cal
    • WIC (Women, Infants, and Children)
    • TANF (Temporary Assistance for Needy Families)
    • SNAP (Supplemental Nutrition Assistance Program)
    •  Subsidized Housing Voucher (Section 8)
    •  Cal Fresh or California Advantage
    • Foster Care
    • Native American Tribe
  • A completed customer registration form with co-payment.

 

Submitting an application is not a guarantee of a scholarship and will not be accepted without a copy of all required documentation and co-payment.

Guidelines:

  1. Scholarship requests are limited to one activity or program per application. Incomplete forms will not be accepted.
  2.  The co-pay must be paid in advance toward each registration fee. (The fee will not be applied until the application is approved and the registration is performed.)
  3. All financial assistance must be applied for in advance, a minimum of two (2) weeks prior to the start of class. Funds will not be given retroactively to classes that participants are already registered for.
  4.  Applications will not be accepted after the deadline date and will not be accepted without a copy of all required documentation.
  5. Scholarships are to be used for registrations only and do not include transportation (unless it is part of the program fee), supplies, materials, or equipment. Drop-in and Membership programs are not eligible.
  6. The applicant and participant must be a resident of San Ramon, and the participant must be under 18 years of age. 
  7. It is intended that this assistance be temporary. Participants may be required to pay full or partial costs. 
  8. Scholarships are awarded on a first come, first serve basis.
  9. Any past due balances must be brought current before a financial assistance application is considered.
  10. All decisions regarding scholarships are final.
  11. Applicants who falsify information or do not attend class regularly may be ineligible for financial assistance.
  12. All applications are kept confidential.
  13. The Scholarship Liaison will notify you within two (2) weeks whether your application is approved or denied.


Step 2:  Eligible Programs:  All classes or camps for participants under the age of 18 are eligible.  Please review our website for available classes.

Registration Website

 

 Step 3: Complete & Submit Application:

Click here to Complete Application

For more information, or if the participant has any extenuating circumstances, please contact Stacy Munsell at (925) 973-3226 or smunsell@sanramon.ca.gov.   

If the request is approved, all required documentation must be submitted with payment and a completed registration form submitted by the required deadline date (Two (2) weeks prior to the class/activity start date) and sent to the Attention of: Stacy Munsell, San Ramon Parks and Community Services Department, 12501 Alcosta Blvd.  San Ramon, CA 94583.