Request for Scholarship: Summer Studies Assistance

Name *

Person filling out this form.

Email *

Person filling out this form.

Student Information

Student Name *

Student Lives With *

Both Parents/Guardians

One Parent/Guardian

OtherOther

School currently attending *

Current grade in school *

Parent Information

Parent/Guardian #1 Name *

Parent/Guardian #1 Email *

Parent/Guardian #1 Phone *

Parent/Guardian #1 Employer *

Parent/Guardian #1 Job Position *

Parent/Guardian #2 Name

Parent/Guardian #2 Email

Parent/Guardian #2 Phone number

Parent/Guardian #2 Employer

Parent/Guardian #2 Job Position

Financial Information

Own or Rent Home *

Own

Rent

Years living in current home *

Total number of children in the home *

Number of children on free/reduced lunch *

Annual Household Income *

Total yearly income for the family

Please share any extenuating circumstances you feel will assist the financial aid committee in evaluating your student's needs.

Summer Study Information

Instrument *

Financial aid awards MUST be used for lessons on the orchestral instrument you play for GCYO.

How will you use the award? Be specific. Provide name of camp or private teacher you will be studying with. *

Total cost of summer program. If private lessons: total = #of lessons anticipated x per lesson cost. *

Financial Aid amount requested. *

Teacher Recommendation: We must receive a recommendation from either the private teacher you are studying with OR a classroom band or orchestra instructor.

Recommending Teacher Name *

Recommending Teacher Email *

Signatures: Entering your name on this application serves as your electronic signature. You affirm that the information provided is true and complete to the best of your knowledge.

Parent/guardian #1 Signature *

Parent/guardian #2 Signature

GCYO does not discriminate on the basis of race, color, ethnicity, disability, religion, sex, creed, national origin, veteran's status, or immigration status. The information shared in this application will be kept private and seen only by the financial aid committee. Please note that financial aid awards will be made contingent on the availability of funds.

Student Information

Parent Information

Financial Information

Summer Study Information

Teacher Recommendation: We must receive a recommendation from either the private teacher you are studying with OR a classroom band or orchestra instructor.

Signatures: Entering your name on this application serves as your electronic signature. You affirm that the information provided is true and complete to the best of your knowledge.

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