Information

Overview

The Kingston Impact Basketball Club recognizes that the cost for a player and his/her family for participating in our Competitive Program can be prohibitive.

In order to allow our programs to be accessible to all, the Kingston Impact has developed a Bursary Program that effectively gives financial aid to a player so that they can participate fully in our Competitve program.

In the 2010-2011 season, the club provided aid for 8 players. We are trying to increase the breadth and scope of our aid but we are limited by our own financial resources.

If you are interested in helping out with a donation or have ideas to improve the accessibility of our programs, please contact our Club President.

Bursary Application

Kingston Impact Competitive Program Bursary Application

This form is to apply to the Kingston Impact Bursary Program for financial support for a player in our Competitive Program. Please fill out the form and submit. A member of the Burary Commitee will follow up. Everything marked with an * is required.

This field is mandatory.

Player Name*

This field is mandatory.

Street Address* Unit/Apart

This field is mandatory.

City*

This field is mandatory.

Postal Code*

This field is mandatory.

Date of Birth (dd-mm-yyyy)*

This field is mandatory.

Team*

This field is mandatory.

Parent/Guardian Name*

This field is mandatory.

Parent/Guardian Primary Phone* Parent/Guardian Secondary Phone Parent/Guardian Email

Please describe other activities in which the applicant will be registered during the time the bursary would be held:

This field is mandatory.

Other Activities*

To support your application, please write a short paragraph below (maximum 10 lines) describing why you are applying for financial assistance in the form of a Kingston Impact Bursary.

This field is mandatory.

Reason*

Provide a reference who is familiar with your situation and who can verify that you require assistance for Kingston Impact. This person should not be a family member or friend but a person who is active in community activities (teacher, coach, social worker, clergy etc.).

This field is mandatory.

Reference Name*

This field is mandatory.

Relationship to Player*

This field is mandatory.

Reference Phone* Reference Email