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HopeS OUTCC <br />700 E. Mountain View Avc. <br />Srite 5C1 <br />Eliensburg, WA 98926 <br />P: 509.925.1448 <br />F:509.925.1204 www. hopesource. us <br />Exhibit "A" <br />Youth Recreation scholarship program Guidelines <br />our mission is to mitigate the effects of poverty and other situations that place a child's social and emotionaldevelopment at risk. The Youth Recreation scholarship is tntenaeJ to n"rp children purti.ipaG in after-school orextracurricular activities. <br />ELIGIBILITY <br />' Lower Kittitas Coynty residents (zip codes 98925, ggg34, 98950, 98946) must have family income at orbelow 60% of Area Medlan Income (see chart on application). <br />' upper Kittitas co11tv residents (zip codes 99922,98925,'gegco, 98941 and 9s943) must have familyincome at or berow B0o/o of Area Median Income (see chart on appiication).' children in foster care qualiff with proof of placement in a licensed foster home regardless of income. <br />ADMINISTMTION <br />HopeSource will administer the diSbursement of the Youth Recreation Scholarship funds on behalf of KittitasCounty, the Law and Justice Council, City of Ellensburg, uniteO wav and the Shoemaker Foundation. <br />APPLICATION <br />Families interested in applying for a Youth Recreation Scholarship will submit their application to Hopesourceeither online or on paper. The apprication shaI incrude the roilowrng:1' Application form (includes address, contact information and infoimation about the activity the child isparticipating in) <br />2. Registration form or other proof of activity cost3' If LowerGounty resident, proof of one month's incomeand names, birth datesand Social Securitynumbers for each family member (oR information on file with HopeSource current within the last year). <br />SCHOLARSH IP-FUN DED ACTIVITIES <br />scholarships can help q9y ror music lessons, art classes, dance, gymnastics, swim lessons, sports leagues, daycamps and more for children age 0-18. The scholarship may ario-be used for equipment for i specific activity ifthe equipment is necessary in order to participate in that activity (for example, soccer cleats for a soccer league). <br />PAYM E NT INFORMATIO N/RESTRICT]ONSo Lower county scholarships:75o/o per application request, not to exceed g75, Limit of g125 per child percalendar year. <br />' upPer County scholarship.s: Up to $100 per activity per child and up to g100 for purchase of equipment.Parents have $10 co-pay, scholarships limited per calendar year to g1,000 per household or g400 per child. <br />Each parent/guardian should anticipate making a monetary contribution to the activity. HopeSource will sendpayment directly to the organization responsible for the aciivity, The organization mult be able to provide a W-9form to HopeSource to receive payment. <br />APPROVAL <br />Upon final approval for funding, an award letter will be issued, we encourage combined resources to help meetthe financial need for the child. <br />6ltsl202r