J. Kline Hobbs Individual Access to the Arts Scholarship

Battle Creek Community Foundation

Purpose: To provide scholarships for individuals to participate in arts and culture programs in Battle Creek.

Eligibility: Any greater Battle Creek area resident wishing to enhance their arts and/or culture abilities. (The greater Battle Creek area is defined as City of Battle Creek, City of Springfield and Townships of Bedford, Emmett and Pennfield)

Criteria for scholarship assistance: This project is designed to provide assistance for Battle Creek area residents who exhibit financial need in pursuing instruction in the arts and culture area. Criteria as follows:

  1. Must exhibit financial need for assistance (documentation is required)
  2. Program must be offered in the greater Battle Creek area.

Selection Process: A committee will determine the scholarship recipient based on criteria.

Individual Applying:

Name: ______Parent name (if under age 18) ______

Email: ______Phone (home) ______Phone (work)______

Address: ______City______Zip:______

Scholarship funding will be used for:

Proposed Expense:

Total Amount Requested:

Demonstration of need (Please describe why these funds are needed, and how much, if any, will be provided by other sources):

Organization to whom this grant will be payable:

Certification: I certify that this application is complete and accurate.

______

NameSignatureDate

This grant is made possible through the Battle Creek Community Foundation.

Please allow a minimum of 15 business days for consideration.

Application Version 2

26April 10

J. Kline Hobbs Individual Access to the Arts Scholarship

Battle Creek Community Foundation

Financial Assistance Form

Individual Applying:

Name: ______Parent name (if under age 18)______

Required Income Documentation

The following documents must be attached to all applications without exception. Originals will not be accepted. Copies must be provided. Documents will not be returned. Please mark out the Social Security number prior to submitting documentation.

ALL APPLICANTS MUST PROVIDE:

  • Two (2) consecutive pay stubs for EACH parent, or unemployment check/verification showing gross and net income. If pay stubs are not available, provide letter of employment specifying gross salary signed and dated by employer on company letterhead.
  • Current registration and class schedule with cost listed, and acceptance letter.
  • Documentation of following benefits (if applicable): Social Security, unemployment, disability, Green/Gold checks, retirement, pension, public assistance, Section 8, TANF (Temporary Assistance to Needy Families)
  • Documentation of dependents not listed on tax return: Medicaid cards, custody agreement, school registration, letter from Social Service for foster children. (if applicable)

SPECIAL CIRCUMSTANCES

List and document any special circumstances that contribute to your request for financial assistance. Please use an additional sheet, if necessary. Examples of special circumstances include: major medical expenses not covered by insurance, separation, divorce, disability, job loss, change in income, etc.

______

NameSignatureDate

This grant is made possible through the Battle Creek Community Foundation.

Please allow a minimum of 15 business days for consideration.

Financial Form Version 2

26 April 10