Youth Program Scholarship Request – Holland Parks and Recreation

Holland Recreation is honored to offer scholarships to children in families with financial need through our Sal Perez Youth Recreation Scholarship Program.

Youth Scholarships are issued based on the Federal Income Eligibility Guidelines to City of Holland Residents. A response to your application is typically sent via email within 72 hours of your submission.

Please create an online account at the sign-in page prior to submitting a scholarship request if you are new to Holland Recreation programs.

Create an account

Scholarship Request

"*" indicates required fields

Name of Parent or Legal Guardian*

First Last

Phone*

Are you a City of Holland resident?*

Yes

Home Address*

Street Address Address Line 2 City State ZIP Code

Email*

Enter Email Confirm Email

Are you requesting a program or equipment scholarship?*

Program

Equipment

List all household members and their birthdate*

(Ex. John Doe; 1/1/64)

Name

Birthdate

Participants & Programs*

Please list all participants (children) and which recreation programs you’re applying for assistance.

Participant Name

Program

Season

Gross Family Income*

Monthly wages of all working family members before tax deductions, child support, unemployment, welfare payments, social security and scholarships.

Does Holland Recreation have permission to contact required parties to verify this information?*

Yes

Do you certify that all the information you have provided is correct?*

Yes

Electronic Signature*

Name of person who prepared the application

Today's Date*