Individual Application for Scholarship

Please read the information and fill out electronic form below

  • (Note: If you are currently not part of a team, please enter “NA”)
  • (Note: If you are currently not part of a league, please enter “NA”)


  • In order to provide financial assistance in a fair and consistent manner, the following relevant documents must be attached and included with your application: Your most recent 1040 federal income tax return (if you file “Married Filing Separately,” please provide both returns) AND Last two pay stubs/LES (military) or Social Security or disability statement (or copy of bank statements showing amount of automatic monthly deposit) OR Profit/Loss statement & business license, if self-employed AND Documentation of any Federal Assistance such as food stamps, rent subsidy or Aid to Dependent Children, AND Documentation of any State Assistance such as unemployment compensation NOTE: If you do not have any of the above documents required, you must submit a letter explaining your personal situation, as well as why you do not have documents. All personal information will be kept confidential and secure.

If you prefer to fill out the form and fax or mail back, please download the pdf below.

Please fill out and fax back.  fax: 630.378.5370

Any supplemental documentation not in electronic format may
be sent via fax above or mailed to address below.


Give Me A Chance Foundation 612 Territorial Drive, Suite B Bolingbrook, IL 60440