Financial Assistance Form ACCC

Financial Assistance Form

Awakening Connections Creating Community
Please fill out this form as a formal request for financial assistance sessions with your school community.

We are grateful to have a grant from Janey Newton to make this possible.
Contact Information
School Name*
Contact Person*

First NameLast Name
Address :*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Phone :*

Area CodePhone Number
E-mail :*
contact person
Workshops
Please choose*

Three half day workshops- Awakening Connection; Creating CommunityBiography of your schoolIndividual workshop 2 hoursIndividual workshop 3 hoursIndividual workshop 4 hours
Assistance

Our typical financial award is between $50 and $900.
Please tell us more about your request for financial assistance, including a dollar figure.
Any additional comments or questions?
Thank you!

We will be intouch within two weeks of receiving this form.
The Center for Biography and Social Art is committed to equal opportunity and does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
www.biographysocialart.org

center4biography@gmail.com
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Financial Assistance Form