| The Legacy Fund Grant Application |
- If you are requesting a scholarship or equipment, please contact the Board of Education and Services for the Blind about possible funding. If your request is declined, include with this application a letter from Board of Education and Services for the Blind indicating the reason for the denial.
- If you are requesting equipment, please contact The NEAT Marketplace Call: 860-286-3113 TTY Toll Free in CT: 866-526-4492 or (860) 243-2869 in the Hartford area for more information or Email NEAT info@neatmarketplace.org
- If you need assistance in preparing this application, you may contact Marcia Watson, coordinator of Blindness Related Supports, at 860-769-3873.
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| Background |
| Personal: |
| Your Name: |
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| E-mail: |
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| Day Time Phone: |
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| Evening Phone: |
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| Address: |
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| City: |
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| State: |
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| Zip: |
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| Professional: |
| Occupation: |
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| Employers Address: |
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| Day Time Phone: |
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| City: |
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| State: |
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| Zip: |
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1 - Amount of Request:
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2 - Activity/Item for which you are requesting funding:
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3 - Time frame for utilizing the funds:
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4 - Are you a former Oak Hill School student:
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5 - Year of graduation or years in attendance:
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6 - Provide a brief description of your past and current activities and accomplishments:
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7 - Describe the item/activity for which you are requesting funding:
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8 - Explain the need for this item or activity:
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9 - Explain what this item/activity will enable you to accomplish:
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10 - Explain how you will benefit from this item/activity:
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| Funding: |
11 - What are the expenses, including shipping/handling, for this item/activity?
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12 - Where did you obtain this estimate?
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13 - Who will be funding each expense item, including you, your family and Oak Hill?
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14 - What other sources of funding did you investigate, including private, commercial and government, and what was the result?
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15 - If there are on-going costs associated with this item/activity, how will you raise these funds?
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16 - What additional Information can you provide Oak Hill that will strengthen your application?
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Provide the information request in The Legacy Application Grant Application
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