Peter Gracey's This is Jamaica / The Strength to Breathe Affiliate Application

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Email *

Program:
*

This is Jamaica

The Strength to Breathe

Suggest another poem by Peter Gracey

First Name *

Last Name *

Name of Organization:
*

Address: *

Phone Number:
*

Name of responsible party:
*

Phone number of responsible party:
*

Email of responsible party:
*

Name of Scholarship Demographic: e.g. This is Jamaica "Florida" or This is Jamaica "Orlando"
*

What prizes offered?
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Suggested duration : Date of Scholarship / Program
*

Do you agree to respect and follow the guidelines and processes of This is Jamaica Inc.?
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Yes

This is Jamaica will provide:
*

Digital Flyers, Video Packaging, Social Media Platforms, Limited Admin Support: What else will you need?

Judges

Radio

Magazine

Visual

Celebrity Appearances

Other

Required

Who should not be allowed to enter: (Affiliation)
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Affiliation to Jamaica

Birth

Student visa

Naturalization

Descent

Enter all

Required

Who will verify Jamaican Affiliation?
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Affiliate

This is Jamaica

Other: Please Explain:

Required

Any special request (criteria suggestion)?
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STEP 2 - Students must follow the instructions and criteria outlined at https://www.thisisjamaica.org/scholarship *

I agree

Required

ACKNOWLEDGEMENT STATEMENT I acknowledge that the information on this application is true and correct and permission is given for the information in the scholarship applications to be shared with those associated with This is Jamaica Inc and Peter Gracey. I release the right to use the information and images contained in scholarship applications, those sent to us during and after the scholarship process for publications, reports and/or press releases. *

I agree

Required

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