Epic Inspirations Scholarship Fund
Date of Submission
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Month
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Day
Year
Date
Are you filling this form out for yourself or on behalf of someone else?
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For myself
On behalf of someone else
Name of person requesting funds
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Preferred contact info for person requesting funds (email or phone)
Name of person filling out form
Preferred contact info for person filling out forms (email or phone)
Please share the budget for this dream or goal: Expenses (e.g. Flights $600, Tuition $700, Admission fees $350, etc)
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Please describe the dream or goal
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Amount requested from Epic Inspirations Scholarship Fund
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Amount covered from another source if applicable
Balance covered by person requesting funds, if applicable
Please tell us how you or the person you are applying on behalf of was involved in creating and sharing the dream or goal below.
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To finalize your application, please confirm the following:
If this plan requires an external approval for expenditure, has that been secured?
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Yes
No
Other
If funds requested from the Epic Inspirations Scholarship Fund, are not approved, will you still be able to pursue the dream or goal identified?
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Yes
No
Other
If this plan requires staff support, are the hours of support approved by the coordinator responsible for your services?
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Yes
No
Other
Signature
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Submit
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