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Town of Waltham, Maine

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Youth Sports & Activities

Scholarship Application

Requirements: Resident of Waltham or Eastbrook

Age Limit: 5 through 20 years of age before December 31 of the year you are applying in.

Date*

Age*

First name*

Last name*

Mailing address*

Home address (if different than mailing address)

Phone*

Email*

Name of Parent(s) or Guardian(s)*

Address of Parent(s) or Guardian(s)*

List your school and community organizational activities*

Scholarship/activity you are applying for*

Full cost*

When is the money due*

Who is the money payable to*

Address where money should be sent*

info@walthammaine.org

1520 Waltham Road

Waltham, ME 04605

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