Thank you Gibson Guitar!

Gibson Guitar Mini-grant Application

Austin ISD staff or Austin Arts organizations that work with AISD students can apply for an electric guitar or a set of guitars to help support their music programs. The guitars must be restricted for student use. Please fill out the following application to begin the process. The committee may ask you for additional information. Deadline for the application is March 29, 2013. Sites will be awarded guitars in April.

If you have any questions, please email brent.hasty@mindpop.org. Thank you and good luck!

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* 1. Contact Information

Name:

Company:

Address:

Address 2:

City/Town:

State:

ZIP:

Country:

Email Address:

Phone Number:

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* 2. What is the percentage of students from AISD that will use these guitars?

	Percentage
AISD	AISD Percentage menu
Non-AISD Students	Non-AISD Students Percentage menu

If not AISD, where do the non-AISD students attend school (e.g. Leander ISD, Charter, Private, etc.):

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* 3. Briefly describe your program including the goals.

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* 4. This program takes place:

During school hours at your campus or other AISD campus

After school hours at your campus or other AISD campus

During school hours at a community venue

After school hours at a community venue

Other (please specify)

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* 5. Tell us how this gift will help your program.

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* 6. How many guitars are you requesting?

If more than 30, how many?

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* 7. Is there anything else we should know about your request?

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* 8. I agree to provide a brief annual report on the impact of the guitars. I agree the guitars will not be sold, auctioned or otherwise disposed of, without consent of MINDPOP. I agree the guitars will be primarily used by students.

yes