Scholarship - City of Concord

City of Concord- Community and Recreation Services 50+ Adult
Scholarship Program
The Concord Senior Center Scholarship program is available to adults 50+
residing in Concord who wish participate in the Community and Recreation
Services Department Program. Approved applicants are eligible for a
maximum of $100.00 per individual per year.
A Senior Center “Registration Form” must accompany each application
and participants are required to pay a co-pay of $5 at the time of
registration. Scholarships are subject to availability.
Scholarships are available for the City of Concord Senior Center Classes,
Day-Trips and Special Events, Concord Senior Citizens Club Activities, and
services for Care Management. Scholarship funds are not applicable for
Bingo or casino trips.
Household must not exceed the following maximum income requirements
based on household size.
Household Size
1 person $18,100
2 people $20,700
3 people $23,250
4 people $25,850
5 people $27,950
6 people $30,000
Maximum Income
Make an appointment to see the Care Manager. Bring your completed
application form. Please call 925-671-3320 for more information,
applications or appointments.
Scroll down to page 2 and 3 to view Application form.

Certification
I hereby certify that the enclosed information is
true and correct to the best of my knowledge.
I acknowledge and understand that the information
provided here will be relied upon for
purposes determining my eligibility to receive
a scholarship from the City of Concord’s
Community Recreation Services Department
and that any material misstatement, fraudulently
or negligently made in this or in any other
statement made by me may result in the
denial of my eligibility to receive a scholarship.
50+ Adult Scholarship Program
Signature of Participant:
Date:__________________________________
FOR OFFICE USE ONLY
Date Received:
Input:
The Concord Senior Center Scholarship
Program is available to adults 50+ residing
in Concord who wishes to participate in
the Community and Recreation Services
Department Program. Approved applicants
are eligible for a maximum of $100 per
individual per year.

Scholarship Process Scholarship Qualifications Scholarship Application
A Senior Center registration form must
accompany each application and participants
are required to pay a co-pay of $5.00 at the
time of registration. Scholarships are subject
to availability.
• Applicant must be a Concord Resident.
• Household must not exceed the following
maximum income requirements based on
household size:
Household Size Maximum Income
1..................................$19,000
2..................................$21,700
3..................................$24,400
4.................................. $27,100
5................................. $29,300
6..................................$31,450
Date:
Name of Applicant (Please Print)
Male Female
Street Address:
Concord, CA Zip:
Phone:
Activity Name:
Activity #:
Scholarships are available for the City of
Concord Senior Center Classes, Day-Trips and
Special Events, Concord Senior Citizens Club
Activities, and services for care management.
Exclusions: Casino Trips and Club Bingo.
CRS-102 MAR2011
• Applications for scholarships will be available
the first week of November.
• Complete application and make an
appointment to see the Care Manager who
will verify proper supporting documents
for income qualification. All information
will be kept confidential.
• Awards will be made along as funds are
available.
Concord Senior Center: 925-671-3320
Care Manager: 925-671-3035
2727 Parkside Circle
Concord, Ca 94519
Please attach one of the following to verify
income. See “Household Size / Maximum
Income” table.
Check one:
Copy of most recent tax return
Food Stamps
General assistance award letter
Letter from employer and/or employment
agency stating monthly income
Letter from care manager, local service
organization, church
$5. 00 Co-pay
Approved: