Vegas Musicians and Artists Fund Application for Aid Question Title * 1. Name Question Title * 2. Email Address Question Title * 3. Phone Number Question Title * 4. What kind of work in our community do you do? Musician/Singer Performing Stage Artist (i.e, non musical, aerial artist, dancer, etc.) Freelance artist (i.e., costume designer, seamstress, makeup artist, photographer) Freelance Sound Engineer Other Other (please specify) Question Title * 5. What level of need do you have currently? Urgent Within the new two weeks. Within the next month. Within the next two months. Question Title * 6. How do you plan on using the aid provided? Food and groceries Medication Rent Household supplies including cleaning products Necessary supplies for children and babies (i.e., diapers, baby wipes, basic care necessities.) Utilities Health Insurance Transportation including gas, car repairs and car insurance Question Title * 7. Secondary Job (if applicable) Question Title * 8. Will your secondary job still provide you income at this time? Yes No I don't know. Question Title * 9. How much income can you expect in the next 30 days from your secondary job? $0 $0 to 500 Between $500 and $1000 Between $1000 and $2000 Over $2000 Unknown Question Title * 10. How many dependents currently live with you? 0 1 2 More than 2 Done