Financial Assistance Application Form (18 and under)

2024-2025 Financial Assistance Request Form

To be completed by dancer's guardian
Guardian Name*

First NameLast Name
Guardian Pronouns
Dancer Name*

First NameLast Name
Dancer Pronouns
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dancer Birthday*

MonthDayYear
Phone Number*

Area CodePhone Number
Email*
example@example.com
Is your dancer or an immediate family member of theirs part of a marginalized group?
Information regarding gender identity, sexuality, ethnic origin, race, disability and more are optional. The information is requested for post-scholarship report generation only and in no way affects your selection for financial assistance. However, priority consideration is given to marginalized dancers and providing this information may increase opportunities where donors have provided additional funding for dancers part of certain marginalized groups.
Does your dancer attend a dance studio? If so, which one?
What event(s) is your dancer planning on attending?*

Los Angeles, CA- Nov 15-17San Jose, CA- Nov 22-24Rochester, NY- Feb 7-9Orlando, FL- Feb 28-Mar 2Boston, MA- Mar 7-9Hanover, Mar 14-16Denver, Apr 4-6Providence, April 25-27Unsure at this time
Is your dancer applying or has applied to be part of one of the following programs?*

Embody Elect ProgramEmbody Ambassador ProgramUnsure at this time
Please make a brief statement describing why your dancer is in need of financial assistance.
We know this takes emotional labor and is not required but we know that sometimes numbers don't match need and we want to give you the opportunity to share.
Guardian occupation / job title *
Additional guardian's occupation / job title
What is the combined annual household income?*
Do you have other dancers planning on attending an Embody event this year?*

YesNo
If selected yes or unsure above, please fill out the following below. If you have selected no, you may skip the following questions labeled a-d.
a) Number of Dependents
Line 6C on 1040, Line 5on 1040 EZ or Line 6C on 1040A.
b) Adjusted Gross Income
Line 37 on 1040, Line 4 on 1040 EZ or Line 21 on 1040 A.
c) Total Income
Line 22 on 1040 or Line 15 on 1040 A.
d) Please upload or email proof of income

Browse Files

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By signing this document, I agree that the information is accurate.
Guardian Name*

First NameLast Name
Guardian Signature*

Clear
Please Note: Financial assistance is not guaranteed. It will be determined based on the viability of your application. Assistance will be given based on the availability of funds and level of need. This application is confidential. The information on the form will not be disseminated. Our team will review your application and get back to you. Thank you for being part of the Embody family!
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2024-2025 Financial Assistance Request Form