Game Changer Application - Healthy Futures

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Challenges that make it hard for you or your team to participate in a sport or recreational activity you love?

Maybe you qualify for a Healthy Futures Game Changer Scholarship:

*Recipients will be chosen and announced every two weeks after a board review of submitted applications*

Game Changer Scholarship Application:

"*" indicates required fields

Name*

First Last

Email*

Phone*

Mailing Address*

Is this for an individual or team/group?*

Individual

Team/Group

Name of team/group*

I am currently between the age of 5 and 18*

Members of team/group are currently between the age of 5 and 18*

Age*

Age range of team/group

I have at least a C average (2.0 GPA) in School*

Members of team/group have at least a C average (2.0 GPA) in School*

Grade*

Name of school in attendance*

Members of team/group are having financial challenges*

My family is having financial challenges*

Do you qualify for free/reduced lunches at school?*

What my team/group needs help with (select all that apply):*

Participation Fees

Equipment

Transportation Support

Other (specify below)

What I need help with (select all that apply):*

Participation Fees

Equipment

Transportation Support

Other (specify below)

Other Explanation

Total amount of funds needed*

Please enter a number less than or equal to 500.

Referral Source*

How did you hear about Healthy Futures Game Changer?

Summary of need*

Why are these funds needed? How will they be used?

Our team/group is willing to share their story with Alaska's News Source

I am willing to share my story with Alaska's News Source

Our team/group is willing to anonymously share testimonial of award experience

I am willing to anonymously share testimonial of my award experience

Parent/Guardian Name*

First Last

Parent/Guardian Phone*

Reference Name*

First Last

Preferably NOT a family member

Relationship to Reference*

Reference Phone*

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Email

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

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HEALTHY FUTURES is a program of the Alaska Sports Hall of Fame

Empowering Alaska’s youth to build the habit of daily physical activity.

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11901 Industry Way, Unit A-9
Anchorage, AK 99515

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Anchorage, AK 99511

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