The following application may be submitted by the hosting organization or the visiting artist themselves. Beneficiaries of this grant are eligible to be considered if the majority have a demonstrated financial need, are between 5-23 years of age, are a resident of Hampden, Hampshire, Franklin, or Berkshire counties of Western Massachusetts, and the majority are from historically marginalized populations. PLEASE NOTE: If your application is successful, SSF requires the completion of a short data collection survey (to be completed by applicant) at the conclusion of your program. Additionally, we would like grant recipients to perform/share an excerpt of your work at SSF’s Spring Gala typically held in March each year. Type of Program (check one)(Required) Field Trip Residency Visiting Artist Project Lead Name(Required) First Last Organization Name(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Email(Required) Phone(Required)STUDENT/PARTICIPANT DEMOGRAPHICSCompletion of this section helps SSF determine whether we are meeting our mission’s goals. Please answer the following questions to the best of your ability. Total number of participating students(Required)How many of your students are eligible for free or reduced lunch?How many are first-time theater goers?How many students come from single-parent households?RACE/ETHNICITYCompletion of this section helps SSF determine whether we are meeting our mission’s goals. Please answer the following questions to the best of your ability. How many of your current participants/students identify as Hispanic or Latino?Regardless of your answer to the prior question, how many of your participants/students identify as:Alaska NativeAsian or Asian AmericanBlack or African AmericanIndigenous North AmericanMiddle Eastern or North AfricanMulti-Racial or Multi-EthnicNative Hawaiian or Pacific IslanderWhiteIf none of the above apply, please specify additional ethnicities and the number of students who identify with each ethnicity:GENDER (Required)Completion of this section helps SSF determine whether we are meeting our mission’s goals. Please answer the following questions to the best of your ability. If this information is already available to you, how many of the participants fall into the following categories?FemaleMaleNon-binaryOtherIf other, please specifyAGE (Required)Completion of this section helps SSF determine whether we are meeting our mission’s goals. Please answer the following questions to the best of your ability. How many of your students/participants are in the following age brackets?5-910-1213-1818-2121-23Your Project/ProgramProgram/Project Name(Required)State your objective in 2-3 sentences(Required)Briefly describe how your project will use theater to promote social justice in your community?(Required)At SSF, we believe social justice theater is a tool for exploring topics that are important in local communities and increasing access to performing arts. By “community”, we mean your immediate community of participants, your audiences and wider community. Describe the project/program and activities(Required)This section is intended for a broader description of your project. Project Details(Required)Examples may include the duration of the program, how many times the program meets, total number of hours of programming.What are your goals for the participants in this project/program? Please be specific.(Required)Ideally, the goals should be tangible, something you intend to measure, and relate to a need in the community where you project takes place. Examples could include literacy, leadership skills, confidence, sense of belonging, self expression or development of performance skills.How do you intend to measure the project's impact and show that you've met your stated goals?(Required)Please share a few questions you plan to ask your participants to measure the project’s impact. Formats for gathering this information could include a survey/poll, interview or short answer questions. Please include the method/format you plan to use. If you have any questions about data collection, please reach out to us. CostsProject/Program FeesVisiting Artist/Residency CompensationTransportationSuppliesTotal Amount Requested(Required)Please attach your line item budget hereMax. file size: 256 MB. Δ