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Does the child qualify for free lunch?
Does the child qualify for reduced lunch?
Certification
The applicant certifies that all information in this application is true to the best of his/her knowledge and belief and no information has been excluded which might reasonably affect a judgment regarding the applicant's eligibility. Signing this application will give the Gloucester Community Development Grants office the right to obtain verification from any source herein.
Penalty for false or fraudulent statement U.S.C
"Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies or makes any false fictitious or fraudulent statement or representations or makes or uses any false writing or entry, shall be fined not more than $10,000 or imprisoned not more than five (5) years or both."
Classes
Please check off classes you would like to take:
Artist's Name (include nickname if needed)
Artist's Name (include nickname if needed)
I would like to be added to the mailing list to receive updates about Art Haven programs.
(This information is confidential and will not be shared with any other party)

Once your application has been submitted, the Art Haven staff will contact you on the status of your application.