2021-22 Gluck Fellow Information Form: Classroom, Ensemble, Family Learning, GluckGlobal, OPA! Fellows (Form 4)
This form is for ALL fellows. Fellows, when you have been notified of your selection as a Gluck Fellow, please complete this information form. Due: August 1 for Classroom Fellows, additional due dates for other Fellows.
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ALL Gluck Fellows: Classroom, Ensemble, Family Learning, GluckGlobal, OPA!
This form is for ALL Fellows and must be completed before you will be scheduled.
Lived Last Name *
The name you use at UCR is now your 'lived' name.
Lived First Name *
The name you use everyday.
UCR SID # *
Student Identification Number - starts with 86. This is NOT your Social Security number.
Stage name
If you would like us to use an alternative name in our advertising and promotion, please let us know.
Preferred Gender Pronoun *
Are you a Domestic or International Student? *
International Students are required to set their tax status in Banner and Glacier, please speak to your Financial Aid advisor.
Class Standing *
Department / Program / Major *
Cell Phone Number *
Gluck Program Title or Ensemble Name *
What is the title of your workshop or student org? If you are in Improvology or the CDE, please state that here.
Brief Biography *
Write in 3rd Person and include your major, minor, educational background, if you are a returning Gluck Fellow, etc.
If you went to school in the Inland Empire, please tell us the names of your schools.
Are you considered 'low income'? *
The Gluck Foundation requires us to report what percentage of the people we serve 'are considered low income', "Low-income in Riverside County for 2021 is: Per family: 1 person -$44,250; 2 persons - $50,600; 3 persons - $56,900; 4 persons - $63,200.  http://www.hcd.ca.gov/grants-funding/income-limits/state-and-federal-income-limits/docs/Income-Limits-2021.pdf
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