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Off The Bench Scholarship Form

Scholarships are available to young women in middle school between the ages of 9 and 14 years. Parents must send a copy of their W-2 form. Add all recipients must express their experience in writing with an action photo if possible and email or post it to Off The Bench, 5237 Mill Dam Road, Wake Forest NC, 27587.

PLEASE NOTE, all forms must be submitted at the same time: Our application, W-2, and the camp application of your choice.


Name:
Address:
City:
State:
Zip:
Phone:
Email:
Birth date:
Emergency Contact:
Parent(s) name(s):
Current school:
Current grade:
Name of soccer team:
Position:
Number of years playing:
Name of coach:
Coach's phone number:
Favorite school subjects:
Other sports played:
Community activities:
Hobbies & other fun activities:
Why would you like to attend soccer camp?
Shorts size:
Shirt size:
Shoe size: