[City of Clarksville] S.P.A.R.K. Scholarship Application

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S.P.A.R.K. SCHOLARSHIP APPLICATION

The Clarksville Parks and Recreation Department strives to build stronger communities by providing a variety of positive experiences and wants to make these opportunities available to everyone. Our S.P.A.R.K. Scholarship Program aims to help families who reside within the city limits of Clarksville qualify for subsidies in the form of discount scholarships. These scholarships allow families to learn, grow, get out and play, and have fun in the Parks and Recreation Department programs.

Am I a City of Clarksville, TN resident?
A resident of Clarksville is any person who lives within the City limits of Clarksville, TN. A nonresident lives outside these limits, regardless of your mailing address. If you are unsure of your residency status, check your zip code (37040, 37042, 37043).

HOUSEHOLD INFORMATION

Head of Household:

Phone Number

Date of Birth:

List the name, gender, age, and date of birth of all individuals residing at the address listed above:

HOUSEHOLD INCOME

Current Household Annual Gross Income:

Number of Household Members:

STATEMENT OF UNDERSTANDING & AGREEMENT

I have read and understand the policy and restrictions for the S.P.A.R.K. Scholarship Program. By signing and submitting this application, I herby agree to the rules and restrictions outlined in the policy. I understand that I must fully disclose all income and herby grant permission to the Department of Social Services to release income and employment information to the Department of Parks & Recreation. I understand there are legal penalties for submitting false information. I understand that I may be subject to a review for eligibility once a year. Clarksville Parks & Recreation reserves the right to request more information, investigate the information and/or deny the application based upon the information submitted.

I certify that all of the above information is true and correct and that all income is reported.

I understand my family must reside within the city limits of Clarksville, TN to be considered eligible for this program.

Yes

Signature of Applicant

First Name

Last Name

Choose how to sign

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Date

Proof of Income (i.e., tax return, government assistance confirmation, or another official record of the household's income)

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Proof of Residency (i.e., Voter's registration card, current driver's license, or other photo identification issued by a governmental entity or utility bill in the head of household's name)

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