Name:
Street Address:
City, State, Zip Code
Email Address:
example@example.com
Phone (cell/home):
Individual’s Name (if applying for an individual scholarship)
Age
Organization Name: (if applying for an organization program)
If you previously applied, or were awarded a scholarship, please describe below (this will not exclude you from applying again).
Grants from the Tempo! Arts for Life Foundation will be awarded to the families, individuals, and organizations with the greatest need. Please explain the circumstances which might make you eligible for funding, how the funds will be utilized, and how the services will benefit you, your family, or organization:
Amount Requested (Up to $400):
(Signature)
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: