» Youth Scholarships

Parent/Guardian Name*

First Last

Parent/Guardian' Email Address*

Parent/Guardian' Address*

Street Address City State / Province / Region ZIP / Postal Code

Parent/Guardian's Phone Number*

Child's Name*

First Last

What program and season do you wish to apply a scholarship to?*

Spring Mountain Bike
Fall Mountain Bike
Spring Adventure Bike Club
Fall Adventure Bike Club
Summer Bike Camp

What level of scholarship are you requesting?*

Full Scholarship (100%)
Three-Quarters Scholarship (75%)
Half Scholarship (50%)
Quarter Scholarship (25%)

Does your child also need to borrow a bike for the program?*

Yes
No
Maybe

Demographic Data

We respect human diversity and your privacy. We ask the following questions to improve the effectiveness of our organization and ensure we address the needs of our entire community.

How many people are in your household?*

*This information is for aggregate reporting purposes only. Your information remains confidential.

What is your total family income?*

Less than $30,000
Between $30,000–$45,000
Between $45,000–$60,000
Between $60,000–$75,000
Over $75,000

*This information is for aggregate reporting purposes only. Your information remains confidential.

Which race or ethnicity best describes you? (Please choose only one.)*

American Indian or Alaskan Native
Black or African American
White / Caucasian
Hispanic
Prefer not to answer

*This information is for aggregate reporting purposes only. Your information remains confidential.

Do you or someone in your household identify as a person with a disability or other chronic condition?*

Yes
No
Prefer not to answer

*This information is for aggregate reporting purposes only. Your information remains confidential.

Name

This field is for validation purposes and should be left unchanged.

Youth Scholarships

Norte Youth Scholarship Application

Demographic Data