Grant Submission Form

If you have received a grant, please follow the following instructions:

1. Please take photo of the front and back of the card that was provided
2. Fill out the form below
3. Once confirmed by our team, they will reach out to you on next steps

Note:  A form will have to be filled out for every player that received a grant.

Si ha recibido una subvención, siga las siguientes instrucciones:

1. Por favor, tome una fotografía del anverso y el reverso de la tarjeta que le proporcionamos.
2. Complete el formulario a continuación.
3. Una vez que nuestro equipo lo confirme, se pondrán en contacto con usted para indicarle los siguientes pasos.

Nota: Se deberá rellenar un formulario por cada jugador que haya recibido una subvención.

Please enable JavaScript in your browser to complete this form.

Parent Name / Nombre de Padre o Madre *

First

Last

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Email *

Phone *

de Player /

Grant type provided / Tipo de asistencia proporcionada *— Select Choice —T-Mobile ($150)Other

Player Name / Nombre del jugador(a) *

First

Last

Amount provided ($) / Cantidad proporcionada ($) *

Amount provided ($) / Cantidad proporcionado ($) *

Minimum Price: $10.00

Please provide a photo of the front and back of the card provided.

Por favor, proporcione una foto del anverso y el reverso de la tarjeta proporcionada.

T-Mobile card OR grant card photo (Front / Anverso) *

Drag & Drop Files, Choose Files to Upload

T-Mobile card OR grant card photo (Back / Reverso) *

Drag & Drop Files, Choose Files to Upload

Copy and paste the following coupon code in the field below and click on the “Apply” button:

GRANT-NO-FEE-COUPON

Apply

* Add “GRANT-NO-FEE-COUPON” to remove transaction fee

Total (transaction fee not included)

$0.00

Financial grant card Information *

Submit