Financial Assistance Request

TheGifted Arts, Inc. is a non-profit organization dedicated to the charitable and educational purpose of providing primary and secondary school children the opportunity to enhance their academic and social development by immersion in performance arts. We are willing to work with dedicated families to provide our programs to all who will benefit from them.

GENERAL INFORMATION

Student Name

First Name

Last Name

Parent Name

First Name

Last Name

Email Address

Current Employer

Length of Employment

Application Status

Date

YYYY

Are you requesting assistance due to hardships related to COVID-19

FINANCIAL INFORMATION

The information requested on this form will be keep confidential. We will use it to help build letters and gather data for individual and corporate grant contributors, donors and sponsors.

Spouse and Dependents Living at Home

Please list all of the persons living within your household. Include their NAMES, EMPLOYER/SCHOOL, BIRTHDATE, AGE, and GRADE.

Is yours a single parent household?

Household Income

What dollar amount are you able to pay?

How long are you requesting assistance?

Please share any additional information about why you are applying for financial assistance:

Assistance Agreement

We are committed to our purpose and mission and we will not allow any barrier to stop any aspiring GiftedArtist to join our cause, especially current financial situations. Our financial assistance program was created to connect donors and sponsors to families in need. In order for our assistance program to continue we must have a commitment on the following items:

Do you agree to the following:

90% attendance of my child in TheGifted Arts Programing

To support in fundraising efforts and events

To volunteer at two opportunities on behalf of TheGifted Arts

I understand that my application will be reevaluated at the end of my assistance term