Individual Financial Assistance Application - Southwest Sports and Fitness Alliance

A portion of the proceeds from the Sowebo Landmark 5K and other fundraising efforts will be awarded to individuals in need of financial assistance for a variety of sports, recreation and camp programs. Eligibility is restricted to families with an annual income of less than $60,000 and children who reside in southwest Baltimore or wish to enroll in programs located in southwest Baltimore. If approved, funds will be issued to the organization/program.

Parent/Guardian Name

First Last

Child’s Name

First Last

D.O.B

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

Amount Requested

Total Cost of the Program

When Are the Funds Needed

Organization Info

Name of Organization

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Organization Owner/Director/Principal Contact

Contact Name

First Last

Contact Phone

Contact Email

Briefly describe the program, activities, length, what’s expected and anything else you wish to add.

Requests will be reviewed reviewed monthly when funds are available. Completion of the application does not guarantee funding. I agree to provide the Alliance with a brief statement describing my impression of the activity that my son/daughter attended, what was gained from the experience, skills learned, etc. Completing this form does not guarantee you will receive any financial assistance. By accepting financial assistance you are also authorizing the use of any testimonials and photos obtained by the Southwest Sports and Fitness Alliance to promote community awareness and seek additional support through social media, grant applications and other means.

Phone

This field is for validation purposes and should be left unchanged.