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The Anyone Can Fly Foundation
Art with Kids Grant Application Form
Please fill in the fields below and mail your application with accompanying documents
to the Foundation not later than February 28, 2007. See full instructions.
Name in full (Surname in capitals)
Place of Birth
 Date of Birth
Sex
 Citizenship
Mailing Address
Street
City
 State
Postal Code
 Country
Home Address if other than above
Note: Home Address must be a Street Address. Do not leave blank.
Street
City
 State
Postal Code
 Country
Telephone Do not leave blank.
 Fax
Cell
Email address
Name, mailing address, and telephone
number of spouse or nearest relative
Name of spouse or nearest relative
Street
City
 State
Postal Code
 Country
Degree
Terminal Degree and Year Issued
Name of Educational Institution
Employer Name and address
Employer Name Do not leave blank.
Street
City
 State
Postal Code
 Country
Supervisor Name
 Telephone
Years Employed
Additional Information About the Applicant
Have you ever been arrested? If so - Why?
Which of the 2005 featured artists do you plan to present in your slide lecture presentation and art-making workshop: Romare Bearden, Elizabeth Catlett, Aaron Douglas, or Jacob Lawrence? Why?
On a separate sheet use the following outline for a visit to a specified museum or art gallery in the winter of 2007 to view the original works of Romare Bearden, Elizabeth Catlett, Aaron Douglas, or Jacob Lawrence. Include:
Motivation:
Performance Objective:
Standard:
Aim:
Materials:
Procedure:
Processing:
Assessment:
Enclose a list of images you will present in the gallery/museum visit.
After completing this form, print it out, sign and date it.


Signature:


Date Mailed:
Click here to return to instructions and mailing address.
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