Multiple Support Request Form

Account # (required):

Program Name:

First Name:

Last Name:

Email:

What are you requesting?
Musical instrumentsMusical instrument accessoriesRepair and maintenance of instrumentsEducational materialsSheet Music and Music CopyrightsBand Room Supplies/EquipmentComputers and Technological SuppliesUniforms, Concertwear, Tshirts, etc.Transportation CostsSpecial Event/Learning OpportunitySpecial Event/Performance OpportunityBrochures, business cards, signage (printing services)Instructor or Guest StipendVolunteersMotivators for the ChildrenOther

Describe specific request and quantity or other details:

Do you have a specific deadline? (Month/Day/Year):

Briefly describe the number of children who will benefit from this request, and any pertinent demographic information of the children who will be served:

How will your request contribute to the success of your program and the success of the children in your program? (as long an answer as needed):

If this request is granted, by submitting this proposal you agree to send the Spirit of Harmony Foundation a report on the outcomes of the request at its completion.