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HopeS OUTCC 700 E. Mountain View Ave. Suite 501 Ellensburg, WA 98926 P:509.925.1448 Fi 509.925.1204 www.hopesotrrce.us Exhibit A: Youth Recreation Scholarship Program Guidelines/ Kittitas County-only funds Our mission is to mitigate the effects of poverty and other situations that place a child's social and emotional development at risk. The Youth Recreation Scholarship is intended to help children participate in after-school sports activities. ELIGIBILITY o Kittitas County must have family income at or below 600/o of Area Median Income,r Children in foster care qualiff with proof of placement in a licensed foster home or with relative caregiver, regardless of income, Child can temporarily reside out of county if Dependency case is within the Kittitas County court system. ADMINISTRATION HopeSource will administer the disbursement of the Youth Recreation Scholarship funds on behalf of Kittitas County and other funders, such as the Law and Justice Council, City of Ellensburg, United Way and the Shoemaker Foundation. APPLICATION ww$r.hqpgqource. us/yputh-sghotarships Families interested in applying for a Youth Recreation Scholarship will submit their application to HopeSource either online or on paper, The application shall include the following: 1. Application form (includes address, contact information and information about the activity the child is participating in) 2. Registration form or other proof of activity cost 3' Proof of one month's income and names, birth dates and Social Security numbers for each family member (OR information on file with HopeSource current within the last year), SCHOLARSHIP-FUNDED ACNVMES WITH KITTITAS COUNTY FUNDS Scholarships can help pay for organized physical activities, which includes dance, gymnastics, swim lessons and passes, spotts leagues and sports/outdoor day camps for children age 0-18. The scholarship may also be used for equipment for a specific activity if the equipment is necessary in order to participate in thal activity (for example, soccer cleats for a soccer league). SCHOLARSHIP LIMITS 75o/o of the cost of a single activity, month of ongoing activity, or equipment. Limit of $150 per child per calendar year. Each parent/guardian should anticipate making a monetary contribution to the activity. HopeSource may consider, on a case-by-case basis, paying the familyb portion of the cost using discretionary funds. PAYMENTS HopeSource will send payment directly to the organization responsible for the activity. The organization must be able to provide a W-9 form to HopeSource to receive payment. 1210612022