Josh Fischer Memorial Fund

Scholarship Form

The Josh Fischer Memorial Fund was established in February of 2000 in loving memory of

Joshua Fischer. Josh was a very active young boy from Deerfield. He had a true passion for

watching and participating in various sporting programs. This memorial fund was established so

that other young children in the Deerfield area could experience the thrill and joy of participating

in sports and/or being a part of a team.

Child.s Name: _________________________________________________________________

Child.s Address: _______________________________________________________________

Child.s Home Phone Number: ____________________________

Parent.s Name: ________________________________________________________________

Daytime Phone Number: ________________________________________________________

Reason you are requesting funds from the Josh Fischer Memorial Fund: _______________

______________________________________________________________________________

Has the above child or anyone in your family received money from this fund in the past? If

so, who received the scholarship and for what reason? _______________________________

______________________________________________________________________________

Application form must be submitted 10 days prior to need

for review by DCC Staff.

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DCC Staff Use Only

I ________________________________ Do / Do not recommend granting the above

child the requested funds from the Josh Fischer Memorial Fund.

Date: ______________________ Amount: _________________