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GALLIM 2024 Financial Aid Application:
Thank you for your interest in joining us at the GALLIM School of Movement.
Please contact Navarra Novy-Williams at
navarra@gallimdance.com
with questions or any accessibility needs, we are happy to assist.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
What program are you requesting financial assistance for?
*
The GALLIM Chicago Experience, July 27-28
Street Address
*
Your answer
City
*
Your answer
State
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Your answer
Zip Code
*
Your answer
Country of Citizenship
*
Your answer
Type of Visa (if applicable)
Your answer
Date of Birth: (XX/XX/XXXX)
*
Your answer
Racial and/or Ethnic Identity.
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American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino/a/x
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White or Caucasian
Declined to state
Other:
Gender Identity.
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Cisgender Man
Cisgender Woman
Gender Neutral
Genderfluid
Genderqueer
Non Binary
Decline to State
Other:
Are you a student?
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Yes
No
Other:
If you are a student, please list your current school below:
Your answer
Do you receive financial aid at your current school?
*
Yes
No
Other:
Have you received financial aid or scholarship from GALLIM in the past?
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Yes
No
Other:
If you have received financial aid from GALLIM in the past, please list the program and year below:
Your answer
If you have received financial aid from GALLIM in the past, please list the amount received below:
Your answer
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