Delia & John W. Haefeli Opportunity Fund Student Application

Delia & John W. Haefeli Opportunity Fund Student Application
The purpose of the Delia & John W. Haefeli Opportunity fund held by The Success Foundation is to provide additional resources to help students reach academic goals, grow personally and/or support professional
and/or career goals.

If need is greater than $500, please contact The Success Foundation at info@d6successfoundation.org or (970) 348-6361.

The Success Foundation will distribute funds through the school where student or students are attending.

Funds requested by a student group must be coordinated by the group and are limited to one application for the group.

*This application must be completed by a District 6 student or student group*
Are you a student or a student group?

Yes - please continue to fill out this applicationNo (please note only applications completed by a District 6 student or student group will be considered)

Student Name requesting funds or filling out the form for a Student Group*

First NameLast Name
(If Applicable) Student Group Name and Names/Grades of Students involved in the request
Student Email*
example@example.com
Student Phone Number
Please enter a valid phone number.
Student School*
Student Grade, if applying as individual
Teacher/Staff Member Sponsoring/Endorsing Request*
Teacher/Staff Member Email*
example@example.com
Teacher/Staff Member Phone Number
Please enter a valid phone number.
Amount Requested (up to $500) *
When do you need to have the funds being requested by?*
Reason for requesting funds: Tell us what need you/your group hopes to address with these funds. If there is already some funding for this need, why are you/your group requesting additional monies? (300 word max)*

0/300
Describe how funds will be used: Clearly explain your plan. What will you/your group use the money for and why? For example, if purchasing items, what will be purchased and how will this help address the needs described above? If you are using funds in other ways, describe those and how they help address these same needs. (500 word max)*

0/500
Are you seeking other funding? If yes, please describe. If no, write N/A. (150 word max)*
Targeted goals: How will this project, if funded, help students reach academic goals, grow personally and/or support professional and/or career goals? Be specific and make sure to describe the connection between you/your group’s plan of action and one or more of these goals. (500 word max)*

0/500

Thank you for your interest in the Delia & John W. Haefeli Opportunity Fund.

If you have any questions, please reach out to info@d6successfoundation.org
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