I hereby certify that I have answered the questions in this application to the best of my ability without any limitations whatsoever; the facts stated herein are true and I understand that any misrepresentation or false information will disqualify me for any assistance from the fund. My signature below constitutes acceptance of this requirement. I also certify that I am providing the information in this application, including personal data which may be sensitive, for the purposes described in this application form. I understand that the personal data I provide, including sensitive personal data, may be factored in to decisions regarding grant awards.

I understand that if awarded financial assistance, I will be referred to a case manager through The Hall’s nonprofit partner, Backline. Case managers will refer individuals to a licensed therapist within Backline’s network that includes over 120 professionals in Colorado. Backline’s network consists primarily of mental health professionals who have experience with or connection to the music industry, as well as an understanding of the unique lifestyle of music touring. Nonprofit partner Sweet Relief Musicians Fund will manage the disbursements from The Hall’s mini-grant fund to the referred therapists as awarded applicants receive treatment.

If awarded financial assistance, I hereby authorize Colorado Music Hall of Fame to communicate with nonprofit partners, Sweet Relief Musicians Fund and Backline, who will assist me in securing mental health resources. Personal data provided to Sweet Relief Musicians Fund or Backline is subject to those organizations’ privacy policies.