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Q-MoB Secure Scholarship Fund Donation Form

By making a tax-deductible monthly contribution or a large donation you can help us build up the funds needed to offer the following three $1000 annual scholarships to queer young adults:

Queer Student College Scholarship for a student who wants to attend one of the colleges in the Greater Berkshire Region
Queer Trades Scholarship for a young queer adult who wants to pursue training in one of the trades and either remain in the Berkshires or return to the Berkshires after their training
Queer Entrepreneurship Scholarship for young queer adult who wants to found their own business in the Berkshires. Funds can be used for any startup costs and will be disbursed with the approval of a Queer Entrepreneur Mentor.

Please note all tax-deductible donations go to Berkshire Stonewall Community Coalition (BSCC), the 501(c)3 organization that is the fiscal sponsor of Q-MoB. Your receipt at the end of the year for your tax deductible donations will come from BSCC.

Amount *
$1,000
$500
$250
$100
$75
$50
$25

Donation Schedule

Contact Information

Name

First Name

Last Name

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Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

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Please let us know if you want your donation used for a specific purpose or in honor of a person. We may not be able to honor your request.