Application Form

Organization Main Contact Name(Required)
Are you Safe Play approved?(Required)

To be approved, this event must:

  • take place during June 2022 
  • include at least 15 participants 
  • demonstrate commitment to diversity and inclusion 
  • incorporate history of Juneteenth 
MM slash DD slash YYYY

Please describe your event and what makes it so special. Include the following information:

  • Facility hosting the event 
  • Target Audience 
  • How you plan to market the event. (social media, flyers, emails, etc.) 
  • How will this event make an impact in your community? 
  • What are you doing to showcase diversity in this event 
  • How the money will be used?