Contact Person *

First Name

Last Name

Phone

(###)

###

####

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

Purpose of Funding

(Select all that apply)

Equipment (wheelchair, racquets, balls, etc.)

Facility Improvement

Funding Request Details (select all that apply)

One-day community events

Adaptive or Wheelchair Tennis Programs

Training, lessons, and/or clinics

In school or afterschool programs

In-house or USTA leagues or Social Events

USTA Tournaments

USTA Junior Team Tennis

USTA Net Generation Programs (e.g., USTA Junior Circuit & Team Challenges)

NJTL

Other (specify below)

Have you previously received funding from Southwest Tennis Foundation?

Yes

No

Target Demographics

(select all that apply)

Adult Tennis

Youth Tennis

People in underserved communities (racial and ethnic individuals, individuals with disabilities, and those living in rural areas)

SafePlay Approval Status

Yes

No

In Progress

Are all faculty members working with youth SafePlay Approve

Yes

No

Acknowledgment and Authorization

Acknowledgment: Terms Agreement: Agree to the terms for any grant awarded, including purpose, accountability, equipment, and publicity requirements. A Final Report will be required for this grant, and a template will be provided to list the expenses related to these funds. If the terms and conditions of the grant are not met, which include completion of the required report and compliance with the USTA’s Safe Play program and its background screening for USTA programs, the organization may be required to return the funds to Southwest Tennis Foundation and will be denied future grant funding.

Yes, I Agree

No, I Do Not Agree

Authorization for Use of Name, Image, and Likeness *

(required) 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: I, the undersigned applicant, 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 my story 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: I understand that I will not receive financial compensation for the use of my name, image, or likeness. 5. Acknowledgement: I acknowledge that the Foundation will use these materials responsibly and in a manner that aligns with its mission to promote tennis and celebrate the achievements of its recipients.

Yes, I Agree

No, I Do Not Agree