Professional Documents
Culture Documents
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Name:________________________________ Artistic Discipline:_____________________________
Email:________________________________ ______________________________
How did you find out about the AAH Program? __________________________________________________
springboardforthearts.org "#$%&$'&!6$,$)4)2$K Three sentences about you and your work. We are interested in you, a description of your
art work, and what motivates you to make the work.
___________________________________________________________________________________________
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"#$%&$!7)(-,#,$%*2!*3!8))95 Please verify that you do not have health insurance or are underinsured and
describe your financial need - Do NOT tell us why you need to access the Community Clinic or share other
medical information with us.
___________________________________________________________________________________________
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6$,$)4)2$!*3!:#;$.3;-2)&&5"
I hereby state that all elements of this application are true.
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(signature) (date)
check one:
! I will pick up my voucher at Springboard’s office
!!Please mail my voucher to the address above