Special Needs Scholarship

Please note: this form is for Special Needs Scholarship requests only.

For General Scholarship information, please fill out our General Scholarship Request.

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Special Needs Champions Division Scholarship Request

Safe Haven Hoops offers scholarships and reduced fees for qualifying Players and families. If you would like more information or to see if you qualify, please use this form and we will contact you shortly about your options.

Player Name *

Parent or Guardian Name *

Parent or Guardian Email

Parent or Guardian Phone

How would like us to contact you? *

Phone

Email

Please Describe your situation *

Please use this field to describe in a few sentences why you are in need of Scholarship assistance.

Security *

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Submit

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For mail-in versions of our Scholarship Request Forms, please download the PDF files located here.

• General Scholarship Mail-in Form
• Special Needs Champions Division Scholarship Form

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Mail & Drop off

Mail or drop off hard copy forms:
Safe Haven West Side Basketball League
c/o Copy Experts
Box 257, 2424 Broadway, New York, NY 10024. (Between 89th and 90st St.)