×
Home Active Fit Program Upcoming Events Community Resources Sample Exercises Healthy Snacks/Menus
www.newarkadvocate.com         www.lmhealth.org         

LMHS Youth League Scholarship Application

Youth League Scholarship Information

Licking Memorial Health Systems (LMHS) provides registration fee scholarships to children who, without this financial assistance, might not be able to participate in one of Licking County's youth recreational athletic leagues. The LMHS Youth League Scholarship program provides opportunities for area youth to participate in recreational team sports as part of our mission to improve the health of the community. Participation in recreational team sports provides physical, mental and character-building benefits.

Currently, LMHS Youth League Scholarships are being offered, but not limited to, the following leagues:

  • AYSO Soccer
  • Granville Recreational District
  • Heath Sertoma Youth Athletic Association
  • Johnstown Youth Athletic Association
  • Lakewood Youth Baseball Association
  • Lakewood Youth Softball Association
  • Licking County Family YMCA Leagues
  • Licking County Sports Association
  • Licking Heights Youth Association
  • Licking Valley Youth Biddy Football League
  • Licking Valley Youth Sports Association
  • Miller Park Diamond Association
  • Mound City Little League & Softball
  • Newark Area Soccer Association
  • Newark Ice Hockey Association
  • North Newark Little League
  • St. Louisville Youth Leagues
  • Southwest Licking Youth Baseball League
  • Summit Station Licking Heights Youth Football Association
  • Upward Basketball
  • Utica Youth Athletics

If you have any questions or need assistance completing the LMHS Youth Scholarship application, please call the Development Department at (220)564-4102 from 8:00 a.m. to 4:30 p.m., Monday through Friday.

Eligibility

To be eligible for the LMHS Youth League Scholarship program:

  • Athlete must be a Licking County resident.
  • Athlete must be age 15 or younger.
  • Household income must not exceed 250 percent of the federal poverty income guidelines.
  • Athlete participates in a minimum of 80 percent of the scheduled practices and games.
  • Participation by a family member in at least one (1) volunteer opportunity during the scholarship season.
  • Athlete or parent must have completed the youth league's registration form.
  • Application must be completed by a parent, guardian, or head of household, with all requested information provided.

Please provide the total gross income for the three months and twelve months immediately preceding the date for which assistance is required. This must include income for everyone living in the home. Write the total gross income in the space provided on the application on the next page. Self-employed applicants must provide gross income, less reasonable business expenses. Personal expenses are not permitted.
Proof of income is required. Examples of acceptable income verification include:

  • Check stubs for 3 and 12 months
  • Documentation of Social Security, unemployment compensation, alimony, child support or pensions
  • Tax Schedule C

If the household earned $0 income, please complete the voucher on page 4 of this application.

 

Option 1: Download, Print and Mail in Application

Click here to download the Youth League Scholarship Application (PDF)

Please return the completed application to:

Licking Memorial Hospital
Development Department
1320 West Main Street
Newark, Ohio 43055
 

Option 2: Complete Application Form Online

Please complete the following form in its entirety.

For suggestions on local leagues for which the scholarship may be applicable, please visit the Sports Activity Resources page. 

If you have any questions or need assistance completing the LMHS Youth League Scholarship application, please call the Development Department at (220) 564-4102, from 8:00 a.m. to 4:30 p.m., Monday through Friday.

Athlete Information
Gender:
Athlete Lives With:
Parent/Guardian Information
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
Additional Information
Consent to Release Information