HomeMy Public PortalAboutPequossette and Kindergarten Scholarship Form 2017_201704060943106493WATERTOWN RECREATION PROGRAM
SCHOLARSHIP APPLICATION 2017
149 Main St. • Watertown, MA 02472
Phone: (617) 972-6494 • Fax: (617) 926-6129
www.watertown-ma.gov • recreation@,watertown-ma.gov
The Watertown Recreation Department is offering a limited number of scholarships for families whose
children would like to attend the Pequossette and Kindergarten Summer Recreation Program and who have a
demonstrated and documented need for financial assistance.
There will a discount offered for Watertown residents only and the assistance will be on a first come first
serve basis.
Please answer the following questions and write a reason that your family should receive assistance.
Include all documentation to verify your information. You must be a resident of Watertown to be considered
for the scholarship. All appropriate documentation must be accompanied with this application in order to be
considered for a scholarship.
Does your family receive benefits from social security disability office? Yes No
Does your family receive benefits from the department of transitional assistance? Yes No
Does your family receive or is eligible for the free or reduced lunch program? Yes No
Please write a brief statement of why your family should receive the scholarship (A separate typed document
would be appreciated).
Submission for scholarship deadline is Friday, June 23, 2017.
INFORMATION: Include only those children who plan to attend this program this year.
Child's Name: Grade (Fall '17): Age: DOB: Gender:
(2) Child's Name: Grade (Fall '17): Age: DOB: Gender:
(3) Child's Name: Grade (Fall '17): Age: DOB: Gender:
Address: Town, Zip:
Mother's Name
Phone: E -Mail:
Father's Name:
Phone: E -Mail:
Please return this form, including all documentation to Peter Centola: Director of Recreation
149 Main Street - Watertown, MA 02472. Questions, comments and concerns can be directed to him at
617-972-6494 or pcentola@watertown-ma.gov
The information included in this scholarship application is accurate and truthful.
Parent(s) Printed Name:
Parent(s) Signature: Date: