SEEK Skateboard Scholarship Application

Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Phone Number *

(###)

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I am applying for a financial Need scholarship *

YES

NO

I am applying for a Full Tuition Scholarship *

YES

NO

Have you attended a SEEK session *

YES

NO

Have you applied in the past *

YES

NO

Phone *

(###)

###

####

Phone

(###)

###

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Gross Income (Both Parents) *

LESS THAT $40,000

$40,000 - $60,000

$60,000 - $80,000

$80,000+

Name *

First Name

Last Name

Phone *

(###)

###

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