Child/Young Adult Individual Theater Class/Camp Grant : Scarlet Sock Foundation

The following application may be submitted by the applicant or on behalf of a child by a parent or guardian, teacher, advisor, or social worker. Applicants are eligible to be considered for a grant if they have a demonstrated financial need, are between 5-23 years of age, and are a resident of Hampden, Hampshire, Franklin, or Berkshire counties of Western Massachusetts, and are from a historically marginalized population.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

STUDENT/PARTICIPANT DEMOGRAPHICS

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.

Does the applicant receive free or reduced lunch?

Does the applicant come from a single-parent household?

RACE/ETHNICITY

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.

DOES THE APPLICANT IDENTIFY AS LATINO OR HISPANIC?(Required)

Regardless of the answer to the prior question, please check off any of the following appropriate boxes for how the applicant identifies:(Required)

ALASKA NATIVE

ASIAN OR ASIAN AMERICAN

BLACK OR AFRICAN AMERICAN

INDIGENOUS NORTH AMERICANS

MIDDLE EASTERN OR NORTH AFRICAN

MULTI-RACIAL OR MULTI-ETHNIC

NATIVE HAWAIIAN/PACIFIC ISLANDER

WHITE

If none of the above apply, please specify:

GENDER

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.

FEMALE

MALE

NON-BINARY

OTHER

If other, please specify

AGE

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.

Age(Required)

Please enter a number from 5 to 23.

Program Information

Program Name(Required)

Describe the program and activities(Required)

What are your goals for participating in this program?(Required)

When does this program occur?(Required)

Costs

Program Fees(Required)

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.