Applicant's Name *

This is the adult applying for minor-age participants.

First Name

Last Name

Adult Phone *

(000) 000-0000

(###)

###

####

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I'm apply for financial help with: *

(Check all that apply)

Classes or Programs

Music Lessons

Does your family qualify for free/reduced lunch? *

Yes

No

Electronic Signature *

I understand that applying for tuition assistance does not guarantee financial help. All applications are kept confidential.

I have completed this form to the best of my knowledge.

Submission Date *

MM

DD

YYYY