Grant Application

Select and copy the following and insert into an email for sberwick@huntermtn.com or paste into a Word document (right and left margins will have to be adjusted to 1/2 inch to acomodate text) and fax to 518-263-3704

HMRF Grant Application - You must be a member of the Hunter Mountain Racing Foundation to qualify for a grant

Date of Application - (MM/DD/YYYY) _________________________

Applicant Name: _______________________________________________

 Male:____ Female:____      Date of Birth (MM/DD/YYYY): _________________

USSA #: __________________________FIS # : _______________________

or other pertinent Competitor ID Number: ______________________________

Mailing Address:

Address: ______________________________________________________

City: ____________________________ State: ______ Zip: ______________

Phone numbers: ________________________________________________

Legal Address (if different from above):

Address: ______________________________________________________

City: ____________________________ State: ______ Zip: ______________

Phone numbers: ________________________________________________

School Attending: _______________________________________________

Currently enrolled as:

Freshman____ Sophomore____ Junior___  Senior____ Other: ____________

Father's Name: ______________________     Mother's Name:___________________________

Occupation: _________________________     Occupation:_____________________________

Employed by: ________________________    Employed by: ____________________________

Other Family Members:         

Name                                           Age              Present School        Involved in snowsports competition?

                                                                                                                                      Prior         Now         Never

______________________      _____         ___________________              ___         ___       ___

______________________      _____         ___________________              ___         ___       ___

______________________      _____         ___________________              ___         ___       ___

Do your parents contribute to your competitions?                  Yes: ____    No: ____

Are you self-supporting?                                                            Yes: ____   No: ____

Do your parents contribute to your siblings' competitions?   Yes:  ____   No: ____

Name of events, dates & estimated costs you will be incurring to be able to compete.

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

How did you qualify for this event? ___________________________________________________

Is any part of your participation in this event paid for by the sponsoring organizations?  If so, please indicate the extent of the aid: _____________________________________________________

Amount of aid requested from HMRF: _________________________________________________

Have you applied for aid from any other sources?  If so, please indicate from whom, and the amount requested: ___________________________________________________________________

If you are requesting more than $500 in financial aid from HMRF, please provide the following financial information:

1.  Salary Income:

                Yours (if self-supporting)                      $ ____________________

                Father's                                                 $ ____________________

               Mother's                                                 $ ____________________

2.  Other Income:                                                   $ _____________________

3.  Total Income from IRS form 1040 or 1040A      $ __________________

Please attach a brief essay about your goals for the season and your future, and the reasons you are applying for this grant.

In signing this application, I represent that the statements made are true to the best of my knowledge.

Signature _______________________________________  Date ________________