Irving S. Gilmore Student Artistic Equipment Grant Application

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Page 1

Student Contact Information

Please enter the student's full email address and select an option from the search results. If the email is not displayed, or you see an incorrect email address (if any), click the checkbox below to manually enter in contact details.

Email Address

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First Name

Last Name

Email Address

Street Address

City

State

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Parent/Guardian Contact Information

First Name

Last Name

Email Address

Phone Number

School

School District of Residence

School

School District of Residence

School

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Current Grade

Page 2

Equipment/Instrument to Purchase

Cost of Equipment/Instrument

If considering several instruments, provide the cost range.

Link to seller's webpage(s) showing instrument

If considering several sellers and/or instruments, provide each link.

Name of Private Instructor

Please select one

Private instructor website/social media link

Attach private instructor resume/bio

Please attach a statement from the private instructor including the following:

their history with the student
how the instructor will assist in choosing an instrument or other equipment

Private Instructor Statement

Page 3

Student question: How have you contributed to the community with your artistic development?

Student question: What are your plans to continue in the arts after high school graduation?

Student question: How will this equipment/instrument prepare you to pursue the arts in high school and after graduation?

Parent question: Describe your involvement with the student's artistic endeavors.

Parent question: Grant awards typically only cover a portion of a purchase of new equipment. Discuss your plan to fund the outstanding charges related to this award.

Page 4

Performing Arts
Please upload a 2-4 minute video recording to YouTube. The video should be based on you, the applicant, preferably as a solo performer. Musicians are encouraged to have a piano accompanist.

Performing arts work sample - YouTube link

Visual Arts
Please upload 5-10 images of your work saved as PDFs or JPEG images.

Literary Arts
Please upload 3-5 pages of written work saved as a Word document or PDF.

Hidden Fields

Contact ID

School District ID

School ID

Page 5

QUALIFIED USE OF FUNDS
Grant funds are for student art activities, including individual and group lessons, workshops, camps, internships, or pre-college coursework.

ACKNOWLEDGEMENT AND PROXY SIGNATURE
Please check the box below. By checking the box below, you:

confirm you will use your grant in accordance with the above qualified use of funds
acknowledge that Kalamazoo RESA will rely upon the submission of this form to ensure funds are used for qualified purposes
agree to return any funds that you are unable to use in accordance with the above guidelines

Note: Award Range is between $150 - $300

I have read and agree to the above terms

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Contact Information