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.
Background
Personal:
Your Name:
E-mail:
Day Time Phone:
Evening Phone:
Address:
City:
State:
Zip:
Professional:
Occupation:
Employers Address:
Day Time Phone:
City:
State:
Zip:
1 - Amount of Request:
2 - Activity/Item for which you are requesting funding:
3 - Time frame for utilizing the funds:
4 - Are you a former Oak Hill School student: Yes No
5 - Year of graduation or years in attendance:
6 - Provide a brief description of your past and current activities and accomplishments:
7 - Describe the item/activity for which you are requesting funding:
8 - Explain the need for this item or activity:
9 - Explain what this item/activity will enable you to accomplish:
10 - Explain how you will benefit from this item/activity:
Funding:
11 - What are the expenses, including shipping/handling, for this item/activity?
12 - Where did you obtain this estimate?
13 - Who will be funding each expense item, including you, your family and Oak Hill?
14 - What other sources of funding did you investigate, including private, commercial and government, and what was the result?
15 - If there are on-going costs associated with this item/activity, how will you raise these funds?
16 - What additional Information can you provide Oak Hill that will strengthen your application?
Provide the information request in The Legacy Application Grant Application