Transgender Summer Camp Application - Eastern PA Transgender Equity Project

Personal Information

Child's Chosen Name*

First Middle Last

Child's Current Legal Name*

First Middle Last

Pronouns*

Parent or Guardian's Name*

First Middle Last

Permanent Home Address*

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

Email*

Phone*

What is the child's Age?*

What is the child's ethnicity?*

Asian
Black / African American
Caucasian / White
Hispanic / LatinX
Native American
Pacific Islander
Mixed
Other

Why are you applying for this Scholarship and how will it help you to suceed?*

Financial Information

Please describe your financial situation including your needs.*

Other Information

How did you learn about this Scholarship?*

Have you ever applied for a grant from Eastern PA Trans Equity Project in the past?*

Yes
No

If yes, what type of grant did you apply for?

Please share any other information that will help the Committee to make a decision with regard to granting financial assistance.

Would you like to receive the Eastern PA Trans Equity Project / LV Renaissance Newsletter?

Yes
No

Parent/Guardian Affirmation

I affirm that the information in this application is true and accurate according to my knowledge and that I authorize Eastern PA Trans Equity Project to Provide Assistance to my child or ward.*

I affirm.

Summer Camp Scholarship

Personal Information

Financial Information

Other Information

Parent/Guardian Affirmation