SYC CONFIDENTIAL Scholarship Application

 

The Shiawassee Youth Chorale, Inc. is a non-profit organization whose mission is to provide a private, supplemental opportunity for musical expression, enrichment, and advancement.  To make it possible for every qualified singer to participate, tuition scholarships are available to singers who have successfully completed the audition process and/or are continuing members. Scholarships will be awarded on the basis of financial need using the income guidelines below, to the extent that scholarship funds are available.

 

To be completed by a parent or guardian – please print neatly.

 

Student Name _____________________________________________ Age________  Grade _____________

Custodial Parent or Guardian:

Name ___________________________________________ Home Phone _____________________________

Mailing Address ___________________________________________________________________________

City _______________________________________________ State___________ Zip___________________

Employer ________________________________________ Work Phone _____________________________

 

Amount of SYC tuition I could afford: $______________

 

Number of family members residing in household at above address: _____________

Do you currently qualify for the Free/Reduced Lunch Programs?  Yes  No

Do you receive financial assistance from any of the following agencies (check all that apply)?

 Family Independence Agency__    Social Security__    MESC __   Other ______________________________

Total Annual Family Income:  $ ________________

 

             I hereby certify that these statements are true to the best of my ability.  I understand that I may need to provide documentation to verify these statements, and that deliberate misrepresentation of this information would disqualify me from scholarship consideration.

                 Signature of Applicant ______________________________________ Date _________________

 

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Office Use:                                                                                   Income Chart – Free/Reduced Lunch Program 2007-08

 

Scholarship Status:

 

___ Approved   Amount $ ________________

 

___Denied

 

 

 

 

 

Updated May 2006