Violet M. Hopkins Fund

Application Form

Please fill out every field below. Use tab key to go from area to area; do not use enter key. Do not press enter until the entire form is filled out. Thank You.

GMO Name	Date of Application

*If you are a chapter of the GMO, please list your chapter name.
Contact Name	Position

Address of Contact Person

City	State	Zip

Phone	Fax

E-mail

1. Instructional program.
A. Describe the program to be supported by this application i.e. is this a camp, clinic, freestyle, seminar, symposia, lecture, pre-certification instructor workshop, sessions for L program participants. OTHER

B. Be specific and give a summary description of the program listed above.

C.What is the need for the program as defined in 1A & B?
D. How will your INSTRUCTIONAL AND EDUCATIONAL program help the participants?

E. If applicable, list the level of riders who will be participating in this clinic program.
(Do not include auditors.)

2. Date(s) of event.

How many will attend?

a) Participants

b) Auditors

We require a fee as an important item for both participants and auditors.

Fee per participant?

Fee per auditor?

Name of Equestrian Facility
Location of Equestrian Facility

3. Instructor's name and qualifications

4. How will you advertise this activity?

5. Who is the desired audience?

6. Other information regarding your clinic that you think the Selection Committee will
find useful in looking at this application

7. What financial help will your GMO give to this clinic?

8. Budget of expenses and income. Please indicate other additional expense and revenue line items for your program with dollar amounts listed:

Expense

Facility

Supplies

Other

Please list other items and expense for each item above.

Clinicians:

Clinician Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Clinician 1 Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Clinician 2 Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Clinician 1 Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Clinician 2 Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Clinician 3 Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Clinician 1 Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Clinician 2 Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Clinician 3 Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Clinician 4 Expense Breakdown

Fee
Food
Lodging
Travel
Other
Clinician Total Expenses

Total Expense

Income
Participant fees for riders
Participant fees for auditors
If applicable, does participant fee include food, lodging?
Grants: Do not include amount requested from The Dressage Foundation. List what financial help your GMO will add to assist your program. What help you will request from your region, and from other groups.
From your GMO
From your Region
From other organizations
Other
Total Income

Amount requested from The Dressage Foundation: (Maximum amount $2,000) If your group is awarded a grant from The Dressage Foundation, how will you promote that TDF is a supporter of this program? Dressage Foundation will grant funding only once in each calendar year to applicant GMO or Chapter of a GMO. If you do not receive a short version of your application, it is your responsibility to contact The Dressage Foundation office. Use the contact item on the website, or phone: 402-434-8585.
Please insert the code below in order to submit your application.



Please double check your work before you press the submit button. Your application will be sent as shown above directly to The Dressage Foundation.

Application

Please read the guidelines before filling out the application.

Violet M Hopkins Grants

Grants Awarded from 1995-2006