First Responders “Thank You” Scholarship Form

We offer scholarship opportunities for first responders (police officers, firefighters, EMTs, and paramedics) with exceptional artistic abilities who wish to further their creative practice. We believe art is a vital avenue for expression, reflection, and community connection and support the first responders in their work.

Student Information

Applicant Name(Required)

First Last

Gender(Required)

Age(Required)

Please enter a number greater than or equal to 7.

Birth Date(Required)

Ethnicity (optional)

White

Black

Hispanic

Asian/Pacific Islander

American Indian/Alaskan Native

Other

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number(Required)

Email(Required)

First Responder

The following information is required to determine eligibility for scholarship acceptance. All information will be kept confidential. Please specify your role as a first responder (e.g., Police Officer, Firefighter, EMT, Paramedic, Dispatcher, etc.):

I am a(Required)

Have you previously taken a class/workshop at GoggleWorks Center for the Arts?(Required)

If applicant is under 18, please provide the following:

Parent/Guardian Name

First Last

Current School

Current Grade

Course Selection:

Indicate the class/workshops you are interested in below. Please note that scholarship seats are offered on a first-come, first-served basis and depend on the current enrollment in class/workshop specified. Age restrictions are noted per class. Any exceptions must be pre-approved by the Programs Department.

First Choice(Required)

Start Date(Required)

Second Choice

Start Date

Third Choice

Start Date

Date(Required)

View Events

View Classes & Workshops

First Responders “Thank You” Scholarship Form

Student Information

First Responder

If applicant is under 18, please provide the following:

Course Selection:

GoggleWorks

Visit

Events

Films

Classes

Galleries & Artists

Venue Rental

About

Support