Fund Application Form

Grant requests for the 2010-11 school year will be accepted beginning August 31, 2010 thru June 1, 2011.

Over the summer months (June 2-August 31, 2011) we do not accept new applications for funding. Please RESUBMIT this application again in the fall if you still wish to obtain Foundation support for your student. Have a good summer.

Please direct any questions to: jody.pollak@oregoned.org

For members requesting funds, please fill in the following information:

Because the OEA Foundation is a statewide organization, please do not abbreviate unless necessary.

* required information Contact  Your Information First Name:* Middle Initial: Last Name:* Job Title:* Home Email:* Address Line 1:* Address Line 2: City:* State:* -- please make a selection --AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaF.S. MicronesiaFloridaGeorgiaGuam HawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingNot in USA ZIP/Postal Code:* Phone:* Additional Information Local Association:* Student First Name, Last Name (office use only):* Student Grade Level (office use only):* Student School (office use only):* Grant Amount Requested:* Description of Assistance Needed:* Does Student Qualify for Free/Reduced Lunch or Oregon Health Plan?:* Free/Reduced Lunch Program Oregon Health Plan Both Other (Please describe below - if you cannot confirm one of the above, provide what info you have that demonstrates need) Describe Family's Financial Situation:* Subscribe to our Weekly eNewsletter! OEA Newsflash General news about OEA work and issue developments that affect Oregon's educators.