DTMFA Scholarship Application - Summer 2021
Dana Thompson is still one of the coolest activists and advocates who enriched and impacted the lives of so many. Dana, a beautiful Black woman, sang in a punk rock band and worked in music, film, theater, and public health. In 2019, Dana was taken from us; gone but never forgotten.

To honor her memory, Dana Thompson Memorial Fund of Awesome (DTMFA) provides scholarships and stipends for Black youth who identify as girls, nonbinary or transgender to participate in Rock 'n' Roll Camp for Girls. We are working to diversify Portland's rock scene and keep Dana’s young, vibrant warrior spirit alive by empowering the next generation.

INFO ABOUT ROCK 'N' ROLL CAMP FOR GIRLS:
"Summer Rock Camp – Hybrid Edition will be a live and online program that is the next step in safely returning to regular camp programming. Campers will join us in our new space in SE Portland for half day sessions, either AM or PM, to learn an instrument; bass, drums, guitar, or vocals, form a band, write a song, and record their song for our virtual showcase. Then in the afternoon, at home, campers will engage in workshops, including logo design and zine making, and performances by our favorite local artists via Zoom."

Check out www.girlsrockcamp.org for more information about camp!

**No prior musical experience necessary!**

DTMFA scholarships include full tuition as well as a cash stipend of $100.

This year we hope to offer scholarships to up to four youth age 9-12, and up to four youth age 12-17.

Campers must be ages 9-17 at the time of their camp session. To be eligible for the DTMFA scholarship, campers should identify as Black girls, trans, or nonbinary youth.

Interested families should fill out and submit this form. We will respond within seven calendar days.

Visit www.DTMFA.org to learn more about Dana and our mission. We are a volunteer-run 501(c)3 nonprofit organization.

If you have any questions, please email info@dtmfa.org or christine@dtmfa.org.

Application closes at midnight on Saturday, May 29, 2021. This deadline may be extended.
Email address *
1.) Who is filling out this form? *
2.) Camper's first and last name *
3.) Age of camper *
4.) Camper's pronoun (examples: she, he, they) *
5.) First and last name of camper's parent or guardian, and pronouns *
6.) Camper's mailing address (including zip code) *
7.) Phone number of parent or guardian *
8.) Email address of parent or guardian *
9.) Level of family income (we believe in Racial Equity and we want to make sure that we prioritize the families of those who could use more support than others) *
10.) Does the camper identify as a Girl, Nonbinary Youth, or Trans Youth? * *
11.) Does the camper identify as Black, African American, or a person of African descent? * *
12.) If the camper is age 9-12, what is your top choice for the in-person portion of camp? (Campers will attend in-person in the morning and work on virtual camp at home in the afternoon, or the other way around. Please note, we can't guarantee you will get to attend during your first choice session.) *
13.) What is your second choice (for campers age 9-12)? *
14.) If the camper is age 12-17, what is your top choice for the in-person portion of camp? (Campers will attend in-person in the morning and work on virtual camp at home in the afternoon, or the other way around. Please note, we can't guarantee you will get to attend during your first choice session.) *
15.) What is your second choice (for campers age 12-17)? *
16.) What needs do you have that we can support you with, to ensure a great camp experience? Please note that musical instruments will be provided. (Check all that apply. Please note that we might not be able to meet every need.)
17.) If you checked "other" above, please list any other needs you may have that we can help with.
20.) Is the camper a past recipient of the DTMFA scholarship? *
18.) We hope to work closely with our scholarship recipients to make sure they have a fun and empowering experience. Is there anything else we should know about the camper? Feel free to share as much or as little as you are comfortable with sharing, to help us get to know you.
19.) What is the best way to contact you (email, phone call, text message)? *
Thank you!
Thank you for your interest and your time. A copy of your responses will be emailed to you.

We will get in touch within seven calendar days of the date you submit this application, to confirm receipt and clarify any details or updates. Selected applicants will be notified on June 1.

PLEASE NOTE: recipients of the DTMFA scholarship also need to fill out the registration form for Rock 'n' Roll Camp for Girls, using a special coupon code that will allow you to register without payment. We can assist with registration if needed.

If any accommodations are needed, please contact us. Requests should be made as soon as possible but at least two weeks prior to the first day of camp.

Please visit our website at www.DTMFA.org to learn more about us and view our Privacy Policy.

If you have any questions please feel free to email Christine Claringbold, board president, at christine@dtmfa.org. Thank you!
A copy of your responses will be emailed to the address you provided.
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