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4th Annual Tyler Frederes Memorial Golf Tournament

07/10/2017, 9:30pm CDT
By Les Teplicky

4th Annual Tyler Frederes Memorial Golf Tournament

TYLER FREDERES MEMORIAL FUND Midwest Hockey Awards Program Application
The Tyler Frederes Memorial Fund was established in 2014.  Tyler was tragically killed in a single car accident on August 17, 2013 while visiting family in Kansas City. Tyler played ice hockey for 16 years and was passionate about the game.  He lived a full life in his short 22 years, and we want to honor him, salute his love of the game and assist players 6 – 18 years old in the Midwest Amateur Hockey Association who have the same passion regardless of their financial situation.
2017-2018 Season Award Assistance from the Tyler Frederes Memorial Fund (TFMF) is based on both financial need and player character.  To have an application considered by the TFMF Board:
 Player and Guardian complete the Player Application Form  Coach or Association Representative provide a letter of reference  Turn form and reference letter into Association President  Association President email completed applications to Midwest Amateur Hockey Association Les Teplicky at teplickylesd@mchsi.com, subject line should read:  MWAHA / TFMF Award
Application Deadline Dates; Travel Player – September 1, 2017 House / Recreational Player – October 1, 2017
 Applications will be kept confidential.  Only one application per family.  Incomplete forms will not be considered.  Association Presidents will be notified regarding successful applicants.  Every attempt will be made to send checks by October 1st for Travel Player applications and November 1st for House / Recreational Player Applications.  Travel Player Applications will be considered past the September 1 deadline and up to October 1, but any awards will be delayed until the TFMF Committee considers all applications.  Questions should be directed to Les Teplicky at teplickylesd@mchsi.com or call 563-320-4933
Player – Parent / Guardian TFMF – MWAHA Awards Program Application Form
Name of Association: ________________________________________________ Name of Player: ____________________________________________________
2017-18 Season:  Travel Hockey _________     House/Recreational Hockey ____________________
Players Registration Fee: ____________
Address: _____________________________________________________ Street: _______________________________________________________
City: _________________________ Zip Code: ______________________
Parent/Guardian:  ______________________________________________ Contact Phone Numbers: 
Home: _____________________  Cell:________________________
E-mail address: ________________________________________________
Number of years played hockey: _________________________________________________
Number of occupants in household: _______________________________________________
Number of household occupants participating in MWAHA: ____________________________
Number of household occupants participating in hockey: ______________________________
Academics: School/Grade:  _______________________________________________________________
GPA (if applicable):  ___________________________
School Extracurricular Activities:________________________________________________ ___________________________________________________________________________ _______________________________________________________________________ Other Activities (including community volunteer service):   ___________________________ ___________________________________________________________________________
Character:   Players, please attach a 1-page essay on why you qualify and deserve assistance from the TFMF.  Coaches will also need to attach a referral letter.
Part 2:  Financial Need
The TFMF Assistance Program is based, in part, on need. In the space below, please explain any circumstances the TFMF Assistance Program Committee should consider regarding your application.  __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________
I hereby state all the supplied information is true and correct. The assistance is for one season, and is not renewable.
Signature: __________________________________ Parent/Guardian Date: _____________ 
Signature: __________________________________ Player  Date:
Return this form to the Association President Request an Association Representative or Coach provide a letter of reference and return letter to the Association President.  The Association President will submit forms and letter of reference to MWAHA Deadline for submission to MWAHA:  Travel players, September 1, 2017 House/Recreational players, October 1, 2017

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