Scholarship

Full Name:

Address:

Phone Number:

Email Address:

DOB:

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Parent/Guardian Name: (if under 18):

Address:

Phone Number:

Email Address:

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Other Parent/Guardian Name (if under 18):

Address:

Phone Number:

Email Address:

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College, University or other institution that you are, or will be attending:

Major:

Have you filled out the FAFSA?

What is your expected family contribution?

What extracurricular activities, such as the arts, are you involved in?

What are your educational goals and how will your education contribute to the arts?

What do you plan to be doing in 10 – 20 years?

Do you have any special circumstances you wish us to consider?

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All personal info is kept confidential. Can we share any information (name, likeness, etc) on our website?

YesNo

Signature (type in name):

Parent/Guardian signature if you are under 18 (type in name(s)):