Application Form

To apply for a grant from Carol’s Fund, you must submit both the application below and the receipts from your unanticipated expense.  The receipts can be scanned and included with your application or mailed separately to the following address:

Carol’s Fund, Inc.
c/o Cliniqa Corporation
288 Distribution Street
San Marcos, CA 92078

Additionally, your coach must submit a letter substantiating your need and the amount of funding on his/her professional letterhead stationery.  Your coach’s letter may be scanned and included with your application or mailed separately to the address above.

Application Form:

Name:*

Age:*

Name of Parent or
Guardian (if under 21):*

Address:*

City:*

State:*

Zip Code:*

E-mail Address:*

Phone:*

Figure Skating Club:

Most Recent Competition
(Name and Date)

Coach’s Name:*

Coach’s Address:*

City:*

State:*

Zip Code:*

Coach’s E-mail Address:*

Coach’s Phone:*

Personal Statement (Include
Reason for Requesting a
Grant and the Amount
Being Requested):*

 
 

 

 

One of Carol's favorite young skaters was Richard Dornbush, whom she first saw skate at Silicon Valley Open in San Jose in 2003. She would have been very pleased when he won the Junior Grand Prix Final in Beijing in December 2010

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