Scholarship application for artist residency Date: Name: Email: Phone: Age: Address: Washington Wyoming Wisconsin West Virginia Virginia Vermont Utah U.S. Virgin Islands Texas Tennessee South Dakota South Carolina Rhode Island Puerto Rico Pennsylvania Oregon Oklahoma Ohio Northern Mariana Islands North Dakota North Carolina New York New Mexico New Jersey New Hampshire Nevada Nebraska Montana Missouri Mississippi Minor Outlying Islands Minnesota Michigan Massachusetts Maryland Maine Louisiana Kentucky Kansas Iowa Indiana Illinois Idaho Hawaii Guam Georgia Florida District of Columbia Delaware Connecticut Colorado California Arkansas Arizona American Samoa Alaska Alabama Is your income below 200% of the Federal Poverty Line? (Please refer to the data below.) Yes No Of the $150 monthly fee, how much can you afford to pay? Submit 2024 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND THE DISTRICT OF COLUMBIAPersons in family/household*…… Poverty guideline (200%)*1$31,3002$42,3003$53,3004$64,3005$75,3006$83,9207$97,3008$108,300For families/households with more than 8 persons, add $5,500 for each additional person.