General Program Acceptance Form

1,000 Dreams Fund Agreement Form

Name(Required)

First Last

Email(Required)

Birth Date(Required)

What program are you a winner of?(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

How do you identify your race/ethnicity? (Please select all that apply)(Required)

College/University

N/A if not applicable

Field of Study

N/A if not applicable

Anticipated Graduation Date

N/A if not applicable

Payment Method(Required)

Please keep in mind that PayPal is our only method to pay international recipients - if you might need accommodations or have questions please feel free to email Staff@1000DreamsFund.org

Please share your PayPal email to send your reward payment if this is your preferred method.(Required)

If you chose check, please put N/A.

Please share the address your check should be sent to if different from above.(Required)

Also please share any details about a different addressee name that we should know.

How will this grant be used?

I hereby understand and accept the terms of this grant award, as specified in my award letter that was provided to me. Further, I understand the following:

(a) My award is only for the current academic year, unless otherwise stated in my award letter;
(b) I will use my funds for the intended purposes in outlined in my answer to the question: "How will this grant be used?"
(c) If I do not meet the requirements explained to me in my award letter, I forfeit any unpaid payments. (d) We work on a Net90 payment system. Meaning that we typically will pay out your grant 90 days from the day we receive ALL forms required, including your online profile as applicable.

Agreement(Required)

I understand