Name:
Email: Complete Address: Phone: Birthdate:
Coach/Advisor:
Coach/Advisor Phone:
**Please advise the RRCA if any of your contact information should change.
Please print a copy of your completed application for your records after you click the Submit button below.
Feel free to send additional information if needed to
Competitive Information:
1. Please list your top athletic performances to date, with special attention to road races. Include race name, race dates, finish places, times and distances. Please list your most recent performances first.
Race
Distance
Time
Date
Place
Additional Races Not Listed Above:
2. What are your road racing and other running related goals (for this year and the next several)?
3. What major road races are you planning to compete in during the next year?
4. What role does your competitive running career play in your life?
5. Describe your training environment. Include such things as: the number of years with your current coach, whether you train with a group, how often you meet for organized practice, and your favorite type of workout.
Income/Financial Assistance Information:
6. What was your total income (adjusted gross income on your tax statement) in 2007 and 2008? This information will be kept strictly confidential.
7. Do you receive any direct or indirect financial assistance (including assistance in cash or in kind from friends, spouse or family) to help you cover the costs of rent, housing, food, insurance (health and automobile) or travel? If yes, please explain in detail.
8. Are you receiving any stipends, grants or financial assistance? If yes, explain in detail, including information identifying the source of assistance, amount and frequency of payment.
9. Do you expect your 2009 income--including full-time job, part-time job, shoe contact, appearance fees, prize money, grants and all other income, athletic and non-athletic--to be less than $30,000?
Yes No
10. Please explain how this grant would help you reach your athletic goals:
11. Do you have contractual or other limitations which would prevent you from wearing clothing bearing the RRCA and its Roads Scholar program logos? If so, please describe the contractual arrangements. Please recognize that the presence of contractual limitations will not prejudice your application.
12. If you have a current or former coach/advisor (or someone else who "knows you as a runner "), please have them submit a letter in support of this application. They may email this to , or mail it to:
RRCA Roads Scholar Program c/o Road Runners Club of America 8965 Guilford Road, Suite 150 Columbia, MD 21046
PLEASE READ AND MARK THE APPROPRIATE CHECK BOXES TO SHOW THAT YOU AGREE:
It is important for the continuing success of the Roads Scholar program that grant recipients represent themselves in a positive light to the media and at RRCA events. Funding for the Roads Scholar program comes from RRCA clubs and supporters. By submitting this application, you are agreeing to the following:
You will be willing to help promote the program so that this funding can continue. To that end, you will:
RRCA National Convention; RRCA booth at a race expo; or RRCA endorsed road race; Attendance and choice of events will be mutually agreed upon by the athlete and the RRCA but it is agreed that two appearances are required in an 18 month period.
If you are selected as a Roads Scholar grant recipient, you will wear RRCA provided clothing such as t-shirts, hats sweaters or an RRCA patch on your racing singlet provided that such apparel or patch doesn't otherwise conflict with the terms and conditions of other clothing related contracts you may enter. You agree to seek permission from any shoe or clothing sponsors to accommodate the use of an RRCA patch. The RRCA recognizes that permission may not be granted to your request.
If you are selected as a Roads Scholar grant recipient, you acknowledge and agree that the RRCA may suspend future payments under the grant in the event that you engage in conduct or behavior deemed by the RRCA to involve fraud, moral turpitude, doping offense or conduct which otherwise has the potential of placing the RRCA or the Roads Scholar program in a negative light. Decisions regarding the suspension of payment shall be made by the Roads Scholar committee and all decisions of the committee shall be final and without further review.
If payments are suspended for any reason specified in this application, the athlete may appeal the suspension to the RRCA Board of Directors. In the event of such an appeal, the athlete shall present his or her arguments supporting the appeal in writing to the RRCA Board within 30 days following the date of suspension. Any decision of the Board in response to the appeal shall be made within 30 days thereafter and the decision of the Board shall be final and not subject to further review.
If you receive a Roads Scholar grant, and it appears at any time during the year while you are receiving payments that you income will exceed $30,000, you will promptly notify the RRCA so the remaining payments can be shifted to another runner.
I certify that the information contained on this form is true and correct. Date:
Please use the space below to elaborate on any other information regarding the questions above that you would like the RRCA Roads Scholar Program Committee to know:
This form must be submitted by March 31, 2009
If you have any questions, contact , or
RRCA Roads Scholar Program c/o Road Runners Club of America 1501 Lee Hwy,Suite 140 Arlington, VA 22209 703-525-3890
The Roads Scholar Committee reserves the right to extend the deadline. Applicants will be notified of any extensions and/or grants or awards via email.
