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HopeS OUTCC <br />700 E. Mountain View Ave. <br />Suite 501 <br />Ellensburg, WA 98926 <br />P:509.925.1448 <br />F:509.925.1204 www. hopesource.us <br />Exhibit A: Youth Recreation Scholarship Program Guidelines/ <br />Kittitas County-only funds <br />Our mission is to mitigate the effects of poverty and other situations that place a child's social and emotional <br />development at risk. The Youth Recreation Scholarship is intended to help children participate in after-school <br />sports activities. <br />ELIGIBILITY. Kittitas County must have family income at or below 60% of Area Median Income. <br />' Children in foster care qualify with proof of placement in a licensed foster home or with relative caregiver, <br />regardless of income. Child can temporarily reside out of county if Dependency case is within the Kittitai <br />County couft system. <br />ADMINISTMTION <br />HopeSource will administer the disbursement of the Youth Recreation Scholarship funds on behalf of Kittitas <br />County and other funders, such as the Law and Justice Council, City of Ellensburg, United Way and the <br />Shoemaker Foundation. <br />APPLICATION <br />www. hopesource. us/youth-scholarshios <br />Families interested in applying for a Youth Recreation Scholarship will submit their application to HopeSource <br />either online or on paper. The application shall include the following: <br />1' Application form (includes address, contact information and information about the activity the child is <br />participating in) <br />2. Registration form or other proof of activity cost <br />3. Proof of one month's income and names, birth dates and Social Security numbers for each family member (OR <br />information on file with HopeSource current within the last year). <br />SCHOLARSHIP- FU N DED ACTIVITIES WITH KITTITAS COU NTY FU N DS <br />Scholarships can help pay for organized physical activities, which includes dance, gymnastics, swim lessons and <br />passes, sports leagues and sports/outdoor camps for children age 0-18. The scholarship may also be used for <br />equipment for a specific activity if the equipment is necessary in order to participate in that activity (for example, <br />soccer cleats for a soccer league). <br />SCHOLARSHIP LIMITS <br />75o/o of the cost of a single activity, month of ongoing activity, or equipment. Limit of g150 per child per calendar <br />year. <br />Each parent/guardian should anticipate making a monetary contribution to the activity. HopeSource may <br />consider, on a case-by-case basis, paying the family's portion of the cost using discreiionaiy funds. <br />PAYMENTS <br />HopeSource will send payment directly to the organization responsible for the activity. The organization must be <br />able to provide a W-9 form to HopeSource to receive payment. <br />t2106/2022