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Clerk's Scholarship for Youth Activities

  1. Applicant
    Applicant must be a residing Hanover Park parent or guardian. Documentation verifying the address and relationship to each child must be submitted i.e. birth certificate, court documents.
  2. Documentation Verifying Relationship*
    Submit One per Child
  3. Relationship verification requires ONLY one document. Please submit document one.
  4. Documentation Verifying Address*
    Submit Two
  5. Address verification requires two documents. Please submit document one.
  6. Address verification requires two documents. Please submit Document two.
  7. Proof of Need Verification
    You may submit documentation of government aid as proof of need. If you are not enrolled in any government aid programs, you will need to submit proof of income. Submit Only One
  8. Proof of Need verification requires ONLY one document. Please submit Document one.
  9. Scholarship Recipient
    List each child and the program's name & cost.
  10. Signature
    Your signature certifying that the information provided is true and correct is required for processing.
  11. Date
  12. Approval- Office Use Only
    Village Clark approval signature
  13. Amount Approved
  14. Program
  15. Fiscal Year
  16. Scholarship No.
  17. Leave This Blank:

  18. This field is not part of the form submission.