The Community School of Music and Arts
   
Scholarship Application p1
   
Date Received: _________
Please print both pages and fill out as completely as possible. If you have questions or concerns about the information requested, please call CSMA at 272-1474
Note: There is a limit of two areas of study per person, per term. Scholarship recipients can take private instruction with one teacher plus one class, OR up to two classes per term.
Student (youth & adults) for whom this application is being made should be listed below.
Name Date of Birth
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
List any additonal dependents other than the students named above.
Name Date of Birth
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Parent/Guardian (or Adult Student) _____________________________________________
Address _________________________________________ Phone _______________________________
City _________________________ State _____________ Zip _______________ Email ________________________________
Employer ____________________________________ Work phone ___________________________

Other Adult Household Member ________________________________________________
Employer ____________________________________ Work phone ______________