Dan Kelly
Foundation

Scholarships

The Dan Kelly Foundation (DK4) is committed to providing athletic opportunities for children of all ages and diverse backgrounds, guided by the belief that everyone is an athlete. We believe that sports can harness the power in kids by building character,teaching perseverance and teamwork, which ultimately builds healthy relationships and makes better community citizens.

Directions

1. Complete all required fields

2. Please use a separate form for each child

3. We will accept one application per child per year.

4. You will get confirmation when the application has been received and you will get
another email indicating the status of our decision within 30 days of submission

Referral of Individual Application

Athlete’s Name

Athlete’s Age

Parent/Guardian

Email Address

Parent/Guardian Contact #

Mailing Address

Application completed by

Contact #

Relationship to child

If you are a School or Town Employee, please tell us school/ department

If sport is was not listed enter it here

Cost$

Name and address of the sports/camp program you are applying for

Phone number of camp/sports program ( if available)

What date do you need the tuition or grant amount by

In a few sentences, tell us why participation in this sport/camp will support this student’s unique needs and social, emotional and/or physical health?

I am the parent/legal guardian and give my permission for my child to participate in this sport/camp and request financial support from the DK4 Foundation.

Signature of parent/legalguardian

Application Date

Would you like to opt in to receive information about the Dan Kelly Foundation

Yes

No

By submitting this application, you consent to The Dan Kelly Foundation (and its advisors and designees) to conduct diligence to verify your qualification to receive a grant. You also acknowledge and agree that such diligence shall not be limited to contact with the individuals listed on this application.

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