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Financial Assistance Requests
Be A Champion Basketball / SF Champions is a San Francisco based non-profit organization devoted to youth basketball. We will consider requests for financial assistance after reviewing the information you provide below. If eligible, we will want to discuss this request with you personally. Eligibility is based on financial need, commitment to attend practices and games, and academic status/progress.
A copy of each player's latest Report Card is required with the submission
of
this application.
Indicate your level of commitment to SF Champions.
*
Indicates required field
Select One
*
Will attend 100% of Practices and Games
Will attend at least 80% of Practices and Games
Will attend less than 80% of Practices and Games
We understand that Fall is a busy time of year with many activities. Please be realistic and truthful when selecting your level of commitment to participate in our program.
Primary Parent's Name
*
First
Last
Please provide the Name of the Primary Parent or Single Parent.
Primary Parent's Email
*
Please provide the Email Address for the Primary Parent or Single Parent.
Primary Parent's Phone Number
*
Please provide the Home Phone Number of the Primary Parent or Single Parent.
Primary Parent's Cell Number
*
Please provide the Cell Phone Number of the Primary Parent or Single Parent.
Secondary Parent's Name
*
First
Last
Please provide the Name of the Secondary Parent (optional).
Secondary Parent's Email
*
Please provide the Email Address of the Secondary Parent (optional).
Secondary Parent's Phone Number
*
Please provide the home Phone Number of the Secondary Parent (optional).
Secondary Parent's Cell Number
*
Please provide the Cell Phone Number of the Secondary Parent (optional).
First Player's Name
*
First
Last
Please provide the First Player's Name.
First Player's Grade
*
Please provide the First Player's Grade.
Second Player's Name
*
First
Last
Please provide the Second Player's Name (optional).
Second Player's Grade
*
Please provide the Second Player's Grade (optional).
Third Player's Name
*
First
Last
Please provide the Third Player's Name (optional). If more than three players, please list these additional players in the "Financial Assistance Request Details" section below.
Third Player's Grade
*
Please provide the Third Player's Grade (optional).
Financial Assistance Request Details.
*
Please describe the reasons for seeking financial assistance. This should include information relating to your current financial situation, your household income for 2013, number of dependents, and information on the player's academic status/progress. Be sure to include any additional information that you feel relates to your request so we may evaluate the best options for providing assistance.
In submitting this form, I certify that the information provided is accurate and truthful. I also understand that the information provided will be confidential and will not be shared with anyone outside of the Be A Champion Basketball organization. Furthermore, I understand that Be A Champion Basketball is under no obligation to grant financial assistance based on this information and additional information may be requested to determine the best options for providing assistance.
* Important: Please print this page for your records prior to submitting.
Submit Request
