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Hyundai Hockey Helpers Grant Application
Hyundai Hockey Helpers Grant Application Please send your grant application to one of the listed organizations that is in the region of your home address. Hyundai Hockey Helpers Grant Application SECTION 1: CHILD INFORMATION Frist Name: Last Name: Address: City: Postal Code: Telephone: Gender: Email: Male: _____ Birthdate – 18 and under (mm/dd/yyyy): Female: _____ Sport activity start and end dates: Start Date (mm/dd/yyyy): _______________ End Date (mm/dd/yyyy): _______________ SECTION 2: PARENT/GUARDIAN Frist Name: Last Name: Address: City: Postal Code: Telephone: Email: Relationship to child: How many adults in home (over 18): ____ How many children in home: ____ How did you find out about Hyundai Hockey Helpers: SPORTSQUÉBEC ___ Sport Organization ___ Website ___ School ___ Recreation Centre ___ Media ___ I agree that all the above information is accurate. Signature: Date: SECTION 3: FUNDING REQUEST Sport: Organization/club/league: Address: Postal Code: City: Telephone: Contact Name: What type of grant: Registration _____ Amount requested (total not to exceed $300): Equipment _____ Both _____ Registration fee: $__________ Equipment: $__________ Total request: $__________ (not to exceed $300) Important (registration): For registration request, please attached sport club registration form to verify registration fee. Important (equipment): For equipment request, please attached quote for equipment from retailer. SECTION 4: INCOME VERIFICATION Gross annual household income (check one): Less than $15,000 _____ $15,-000 - $19,000 _____ $20,000 - $29,999 _____ $30,000 – 39,999 _____ $40,000 & over _____ Hyundai Hockey Helpers Grant Guidelines: 1. How does KidSport determine eligibility? KidSport considers social and economic barriers facing the child’s family when determining eligibility. 2. What is covered under the grant? A Hyundai Hockey Helpers grant covers up to $300 per child, per calendar year, to go toward registration fees and personal sports equipment. 3. What sports are covered? Hyundai Hockey Helpers grants cover organized hockey that is instructed by qualified coaches and that represents a sustainable sports experience. 4. What ages are covered? Children 18 years old and under qualify for funding. 5. What are the funding arrangements? Funds for registration fees will be providing to the family to distribute, but will be issued and made payable directly to the sports club, o to the retailer in the case of equipment purchases. QUESTIONS? Call 514-252-3114 #3616 or email [email protected] Please send your grant application to one of the listed organizations that is in the region of your home address. Hyundai Hockey Helpers Grant Application Please send your grant application to the organization that is in the region of your home address. SPORTSQUÉBEC partner list Hyundai Hockey Helpers Region AbitibiTémiscamingue Baie-James Organization Loisir et sport AbitibiTémiscamingue Commission Loisir et Sport de la Baie-James Unité Régionale de Loisir et de Sport du Bas-SaintLaurent Unité de loisir et de sport de la Capitale-Nationale Loisir et Sport Côte-Nord Loisir Sport Centre-du-Québec URLS Chaudière-Appalaches Unité régionale loisir et sport Gaspésie-Îles-dela-Madeleine Conseil Sport Loisir de l’Estrie Loisir et Sport Lanaudière Loisirs Laurentides Contact Joanne Aumond Maude Poulin Lemieux Michel Morissette Outaouais Conférence régionale des Élus de Laval Unité régionale de loisir et de sport de la Mauricie Sport et Loisir de l’Île de Montréal Loisir et Sport Montérégie Loisir sport Outaouais Saguenay Lac StJean Hockey Saguenay-LacSaint-Jean Marco Lavoie Bas-Saint-Laurent Capitale-Nationale Côte-Nord Centre-du-Québec ChaudièreAppalaches Gaspésie-Iles-dela-Madeleine Estrie Lanaudière Laurentides Laval Mauricie Montréal Montérégie Richard Leclerc Josée Longchamps Diane Roy Jessie Tanguay Dominique Viens Marie-Pier Breton Magalie Forest Émilie Roy Martin Bradette Richard Leduc Céline Brosse Patrick Lafleur Guy Arcand Information [email protected] 819-825-2047 [email protected] 819-739-2273 [email protected] 418-723-5036 #230 [email protected] 418-877-6233 #101 [email protected] 418-589-5774 [email protected] 819-478-1483 #238 [email protected] 418-833-5678 #103 [email protected] 418-388-2121 [email protected] 819-864-0864 [email protected] 450-588-4443 [email protected] 450-229-2200 [email protected] 450-686-4343 [email protected] 819-691-3075 #6534 [email protected] 514-722-7747 #0 [email protected] 450-371-0544 [email protected] 819-663-2575 #25 [email protected] 418-542-7996 Please send your grant application to one of the listed organizations that is in the region of your home address.
