Rita B. Scholarship Scholarship Program ApplicationApplicant InformationApplicant First Name (primer nombre): *Applicant Last Name (Apellido) *Applicants Age (la edad): *Parent/Guardian's Name (Nombre del Padre de Familia / Guardian)Size of Family *Physical Street Address (dirección física) *Apartment, suite, etcCity *State *Your Phone Number (Número de teléfono): *Email Address (correo electrónico) *Background on organization offering the activityName of Organization (nombre de organización) *Contact Name *Address (Dirección): *Apartment, suite, etcCity *State *Phone Number *Email Address *Website (If known)Activity InformationActivity / Activity Need / NeedsDate(s) of activityEstimated CostHow will you benefit from the requested recreation activity?Letter of reference (i.e. from a teacher, neighbor, doctor etc) are optional and may be attached/submitted. All applicants are welcome to submit with this application any additional information that would pertain to being considered for scholarship assistance.Drag and Drop (or) Choose FilesI certify that to the best of my knowledge the information I have provided is true. *I Agree Submit Registration Form NowPlease do not fill in this field.
