Community Access Fund Application

Thank you for your interest in our Community Access Funded programs. The board and staff of the Tech Valley Center of Gravity are committed to the values of equity, diversity, and inclusion. We seek to create a genuine, inclusive, and safe environment for makers of all backgrounds. We promote the uniqueness of personal identity and encourage applicants from traditionally under-represented communities to apply to our programs. If you have questions or need assistance filling out the application form, please contact us at admin@tvcog.net.


The Community Access Fund currently supports multiple  programs, but this application is only required for the Pay-What-You-Can Membership Program. The applications for these programs are accepted on a rolling basis, and have no set deadline. Applications will be reviewed by TVCOG staff upon receipt; applicants will be contacted regarding the status of their application within 7-14 business days of submission. We may ask you to conduct a follow-up interview, which can be conducted either in-person or via phone/video call. Applicants are encouraged to reach out with questions regarding the program requirements or specifics at any time via email to info@tvcog.net


These programs start the first week of each month. For example, if your application is approved in October 2023, your membership would begin on November 1, 2023.


Please note that these programs are limited to individuals who currently have an individual income below $39,526, which is the currently listed median income average for residents of Troy, NY


If you have any questions about this application, or any of the programs listed above, please feel free to reach out to us via email at info@tvcog.net or via phone at 518-344-2544. 


Regarding family memberships: we offer a 50% discount on Maker and Super Maker memberships for family members of COG members. Members of any community access funded programs will be eligible to take advantage of this discount. Approved applicants will be contacted regarding this option upon the start of their memberships. 


Basic Information

Applicant Name:
Pronouns:
Mailing Address:
Email Address:
Phone Number:
Your preferred contact method:
Email (default)
Phone
Standard Mail
What is your preferred reduction amount? Please note, we may offer you a lower reduction amount than what you select here; our standard reduction amount is 50%. Reduction amounts are approved based on demonstrated financial need; as such, applicants who ask for a reduction greater than 50% are encouraged to submit a detailed statement of need.*
25%
50%
75%
100%
How long do you anticipate participating in the Pay-What-You-Can program?We are able to offer up to 1 year of assistance, depending on availability of funds. Please provide us with an estimation of how long you may need to participate in this program; please feel free to approach staff to discuss any adjustments should the answer change during your participation in the program,
Are you a current TVCOG Member?
Yes
No, but I had a membership in the past.
No, this would be a brand new membership.

Financial Information

We are required to gather the following information in order to accurately provide reporting to our sponsors. All information will be kept confidential. 

Check all that apply:
My current individual annual income is below $39,526
I currently receive public assistance (e.g SNAP, HEAP etc.)
If you would like to make a statement of need, please either attach a file or enter in the text area below:This field is not required, but is encouraged for all applicants. It is especially encouraged for applicants seeking reduction amounts greater than 50%.
Attachments here:
Drag & Drop Files Here Browse Files

Personal Statement

Why are you interested in the program? (Please provide 1-3 paragraphs)*Why are these questions included in the application? This program is funded by a variety of sponsors and donors. We use the information collected in the following questions to meet sponsor and donor requirements. All information is kept confidential and names are not shared with sponsors or donors.
What type of skills and/or experiences are you looking to gain during your time in the program?*
How do you learn best? For example, hands-on learning, lecture-style, online etc. *

Demographic Information


The board and staff of the Tech Valley Center of Gravity are committed to the values of equity, diversity, and inclusion. We seek to create a genuine, inclusive, and safe environment for makers of all backgrounds. We promote the uniqueness of personal identity and encourage applicants from traditionally under-represented communities to apply to our programs. 


The following questions are completely voluntary, and are for grant reporting and informational purposes only. 


If you would prefer not to answer, you can just leave the field blank. All answers will be kept completely confidential.

In your own words, how would you describe your race and/or ethnicity?
What is your gender?
What is your current employment status?
Do you identify as a member of the LGBTQIA+ Community?
Yes
No
Which Generation do you belong to?
Generation Z (Born 1997 to 2012)
Millennials (Born 1981 to 1996)
Generation X (Born 1965 to 1980)
Baby Boomers (Born 1946 to 1964)
Silent Generation (Born 1928 to 1945)
What obstacles or challenges do you face in seeking a safe and inclusive environment?
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