#DiversifyIceHockey Sponsorship

ICE HOCKEY

About the Scholarship:

-open to underrepresented hockey players on a hockey team (synchro and hockey)

-funding to support or offset equipment (skates, helmet, pads, private lessons)

-must demonstrate noticeable talent at an early age.

Application

First Name

Last Name

Date of Birth

Gender

Female Male Transgender Female Transgender Male Prefer Not o Answer

Race / Ethnicity

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Hispanic or Latino Non Hispanic Non Latino

Competitive Level

US Figure Skating Number

Skating Club

Skater Home Rink

Video URL web/ address (Youtube etc.) of you skating (competition)

Video URL/ web address (Youtube etc.) of you skating (Practice/ Training)

Accomplishments (Event, Level, Placement)

Do you have at least one underrepresented skater at the international competitive level (eg. Team USA)Do you have at least one underrepresented skater at the National competitive level or on the National developmental team?

Upcoming Events?

What are your primary needs

Support with Ice time costs Support with lesson costs support with skate equipment support with costumes support with travel to competition/ test/ shows Mentorship show opportunities Networks

List your top 3 primary needs from the previous question

Would you be interested in using preowned equipment?

Yes No Maybe

What size skate do you wear?

What size dress do you wear?

What size pants do you wear?

Parent's First Name

Parent's Last Name

Parent’s/Guardian’s Gross Income for FY 201

Do you receive any other financial support from someone else other than your parent/guardian? *

List sources and amount of support you receive annually (ex. Clothing Co., $1800)

Coach's First Name

Coach's Last Name

Coach's Email Address

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