Artist Clinic Grant Request Form

GRANT REQUESTS MUST BE SUBMITTED A MINIMUM OF 30 DAYS BEFORE THE EVENT
Today's Date*

MonthDayYear
Date
Event Date*

MonthDayYear
Date
Your First Name*
Your Last Name*
School/Association Name*
Street Address*
City*
State*
Zip Code*
Email*
example@example.com
Phone Number*
Name of the Event*
Location of the Event*
Time of the Event*
Approximate Number of Audience*
Clinician's Name*
Clinician's Instrument*
Name of Your KHS America Dealer*
FINANCIAL INFORMATION
Clinician Fees*
Clinician Expenses*
School Contribution*
Dealer Contribution*
Grant Amount Requested from KHS America*
Should be Empty: