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. 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 AfghanistanAlbaniaAlgeriaAmerican 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 RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican 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 RicoQatarRomaniaRussian FederationRwandaRéunionSaint 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 TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands 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-binaryOther If other, please specify AGE (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) Describe the project/program and activities(Required)When does this project/program occur?(Required)What are your goals for participating in this project/program?(Required)How will you evaluate if you’ve met your goals or not?(Required)CostsProject/Program Fees Transportation Supplies Total Amount Requested(Required) Expectations from Scarlet Sock Foundation: Completion of a short data collection survey (to be completed by applicant or the person completing this application) and an invitation to present at SSF’s annual spring gala. Δ