Jenine Stickler Memorial Fund Group Application Please enable JavaScript in your browser to complete this form.Applicant/InstructorNameTitlePhoneEmail *DescriptionDescribe the traditional art instrument or art supplies needed, the group activity, the number of youth and the cost per unit (Example: The weekly Uke Club teaches 30 ten year olds who are ni need of instruments/cases at $50 each or total of $1500.)CostsCost per unit ($50 or less)How many units?TotalTotal must not exceed $1500 per application.Describe the group and training/instruction offered.Attach a jpg or pdf of art "tool" to be purchased. Click or drag a file to this area to upload. Attest that children ages 3-18 that live or attend school in Mecosta, Osceola, Lake, Newaygo or Montcalm Counties in Michigan will be served -Community SectionCheckboxesYesAgesCommunity/CountyThe group/community to be served has financial need (according to Census/EDA high poverty rate among children, free/reduced lunch rate, other).Confirm other costs, if any, will be raised/committed. Amount raised/committed locally (optional):Enter dollar amount.Executive Director, Superintendent or Principal approves submission of this application, and by signing agrees to: 1) Make the purchase 2) Complete instruction 3) Distribute items to children and ask parents/youth to own/maintain the items) and refrain from selling the items) for at least 3 years. Signatory Name/TitleOrganization/SchoolAddressDateSignatureClear SignatureName for check to be made out to (if approved):Submit