Please complete the following to request SVSA Financial Assistance

PLAYER INFORMATION
Player Name *
Player Name
Phone *
Phone
Cell: *
Cell:
Date of Birth *
Date of Birth
Academy Team Age Group?
1ST PARENT
1st Parent Name *
1st Parent Name
Phone *
Phone
Cell
Cell
2ND PARENT
2nd Parent Name *
2nd Parent Name
Phone *
Phone
Cell
Cell
Assessment of Need
PROOF OF NEED
Please submit your completed application along with proof of need. Documentation can be emailed to info@svsa.org or sent to SVSA, PO Box 1023, Redwood City, CA 94064. The financial aid request IS NOT COMPLETE WITHOUT THIS INFORMATION:
Required Documents (must be current) *
Terms of the SVSA Financial Assistance *
I/We understand that I am obligated to pay the $250 Registration fee to Silicon Valley Soccer Academy. If I/We withdraw my child after signing the financial aid contract agreement, I/We understand that SVSA would suffer monetary damages and agree to, as liquidated damages and not as a penalty, the fee for the year as set forth in this agreement. After signing the Financial Aid Application, no portion of such fee will be refunded or canceled in the event of absence, withdrawal or dismissal from Silicon Valley Soccer Academy. In addition to the registration fee, I/We agree to pay other charges set forth in the Financial Aid Program, and recognize that the following provisions apply: Account balances not paid by the 25th of any month become delinquent at that time and are subject to a finance charge of $10.00. Until all overdue payments have been made, SVSA may refuse enrollment of or suspend your child. Such action shall not relieve me of the obligation of any overdue payments. In the case where more than one parent is responsible for payment of the program fee, it is the responsibility of the parents to agree on the terms that will work for them. SVSA is not responsible for the collection of multiple parties. SVSA will require the parents jointly, to be responsible for the timely payment of fees and any other charges regardless of their personal allocation of responsibility for the payment or appointment of a designated payer. Financial assistance is not guaranteed and is dependent of the eligibility of the applicant and availability of funds at the time of the request. I/We, the applicant, have read and agree to the terms of the Silicon Valley Soccer Academy Financial Aid Policy and any requirement outlined on this application. I am requesting that our child be placed on the Financial Aid status with SVSA. Everything I have stated in this application is true and complete to the best of my knowledge.
Electronic Signature *
Electronic Signature
Date *
Date