Your Information *

First Name

Last Name

Phone

(###)

###

####

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Player(s) Name *

First Name

Last Name

Phone *

(###)

###

####

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

USTA Membership Status

Are you or the person receiving the funds from this application a USTA Member?

YES

NO

USTA Region

Northern Arizona

Phoenix

Southern Arizona

Northern New Mexico

Southern New Mexico

Greater El Paso Area

Ethnicity (select all that apply)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Two or More Races

Prefer Not to Answer

Is the Player of Hispanic, Latino or Spanish Origin? *

Yes

No

Gender

Male

Female

Prefer not to say

Funding Request Details (select all that apply)

Equipment (wheelchair, racquets, balls, shoes)

Coaching Expenses

Travel Expenses

Tennis Programs, Camps, or Leagues (USTA or In-house)

Court Costs

Group Classes

Private Lessons

Tournament Fees

Tennis Academy Tuition Fees

Other (specify below)

Have the player(s) previously received funding from Southwest Tennis Foundation, Southwest Section, Regional Association, or USTA National Foundation?

Yes

No

Eligibility

It is the sole responsibility of the applicant to contact their State High School Athletic Association and/or NCAA to determine whether the receipt of a grant will adversely affect their eligibility to compete. Has the applicant confirmed with the proper authorities that this grant will not adversely impact individual/team eligibility?

Yes

No

Acknowledgment and Authorization

Please note that the player must: ● Be in good standing and may not have suspension points or penalties imposed by any tournament committee or administrative body. ● Agree to follow up with a written summary and images of how the funding awarded has impacted the applicant. ● Have USTA membership verified.

Yes, I Agree

No, I Do Not Agree

Authorization for Use of Name, Image, and Likeness *

As part of our mission to share inspiring stories and celebrate the achievements of our grant and scholarship recipients, the Southwest Tennis Foundation may feature your name, image, and likeness in promotional materials, publications, and communications. By accepting a grant or scholarship from the Southwest Tennis Foundation, you agree to the following terms: 1. Authorization: Player(s), the undersigned applicant(s), hereby authorize the Southwest Tennis Foundation to use my name, image, and likeness in any format, including but not limited to photographs, video recordings, and written content. 2. Purpose: This authorization allows the Foundation to feature stories or achievements in materials such as: ○ Social media posts ○ Website content ○ Annual reports ○ Press releases ○ Event promotions 3. Scope and Duration: This authorization is granted without geographic or time limitations and applies solely to the mission and activities of the Southwest Tennis Foundation. 4. Compensation: Players understand that they will not receive financial compensation for the use of their name, image, or likeness.

Yes, I Agree

No, I Do Not Agree