Faribault Soccer Association
Request for Financial Assistance

Name:_________________________________ Date:_____________

Address:_________________________________________________

City:_______________________ State:____ Zip:________________

Player Name:____________________________________________

Please explain why you should be considered for financial assistance:

________________________________________________________

________________________________________________________

________________________________________________________

________________________________________________________

________________________________________________________

The most Financial Assistance granted is 50% of the fee.
Uniforms are extra, if needed.

We will accept up to 3 monthly payments for those who can't come up with the entire amount at one time. It must be paid in Full by April 15. Please speak to the Registrar or Board member regarding this.
All information is kept confidential. Only the executive board will know who is approved.

Signature of parent or Legal guardian_____________________________

print and send to:
Troy Temple (president)
922 Newhall Drive
Faribault, MN 55021