DO YOU NEED FUNDING FOR SOMETHING NOT COVERED BY ANOTHER SSF GRANT? IF SO, CONSIDER SUBMITTING A MISCELLANEOUS GRANT APPLICATION! 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 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.Does the applicant come from a single-parent household?YesNoDoes the applicant come from a single-parent household?YesNoRACE/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.DOES THE APPLICANT IDENTIFY AS LATINO OR HISPANIC?(Required)YesNoRegardless 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: GENDERCompletion 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 AGECompletion 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.Your Project/ProgramProgram/Project Name(Required) Describe the project/program and activities(Required)What are your goals for participating in this project/program?(Required)When does this project/program occur?(Required)How will Scarlet Sock funds be applied to your project?(Required)CostsBreakdown of Costs(Required)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