2020-21 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.
Legal Last Name *
The name on record at UCR.
Legal First Name *
The name on record at UCR.
UCR SID # *
Student Identification Number - starts with 86. This is NOT your Social Security number.
Preferred Name/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 / 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 2019 is: Per family: 1 person -$40,250; 2 persons - $46,000; 3 persons - $51,750; 4 persons - $57,450.  http://www.hcd.ca.gov/grants-funding/income-limits/state-and-federal-income-limits/docs/Income-Limits-2019.pdf
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