The Las Vegas Firefighter Youth Hockey organization (LVFFYH) provides financial assistance (adjustments) to families and individuals who may not have the financial means to keep their children enrolled in Las Vegas area youth hockey programs. The membership assistance committee has been entrusted with the responsibility of operating the LVFFYH in a prudent manner and therefore it is necessary to review all requests for financial aid or adjustments annually. The information you provide will be used solely to determine your eligibility for assistance and will be kept treated with the utmost of confidentiality. All requests require the approval of the Membership Assistance Committee.

General Instructions:

  1. Please answer all questions completely.
  2. Submit the first two pagesof last year’s tax returns.
    Please note: LVFFYH will not make copies of your tax filings
  3. Please Sign, date and place form in a sealed envelope prior to returning it to the LVFFYH.
    Any questions, please call Julie at 702-204-6602

Please mail or fax application and required documents to:
Julie Ann Littmann
10300 West Charleston Blvd #13-234
Las Vegas, Nevada 89135
Fax number is 702-233-6469

Click to download this form or submit the form below.

Employment Information

Expenses

Vehicle 1:

Vehicle 2:

(Gas, Electric, Cable)