Countryside Little League - Scholarship Request Form CSLL Scholarship Request Form Question Title * 1. What is the player's name requesting a scholarship? Question Title * 2. Who is the parent/guardian requesting a scholarship for baseball/softball at Countryside Little League? Name Address City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Email Address Phone Number Question Title * 3. Is the player currently receiving free / reduced lunches at school? Receiving free lunch at school Receiving a reduced lunch at school Not receiving and free or reduced lunch at school Question Title * 4. If not receiving free / reduced lunch at school, please describe a reason for the scholarship request? Question Title * 5. If a scholarship is offered, would the parent / guardian be willing to help volunteer for Countryside Little League? If so, what would the parent/guardian willing to do? Question Title * 6. I understand that I may be required to provide proof of the above information. I understand that the information above is accurate and true and misrepresentation will void the scholarship. You must complete the registration process. I agree with the statement above. I do not agree with the statement above. Done