Name: (First, Middle Initial, Last)

E-Mail Address:

Date of Birth: (Month, Day, Year)
JanFebMarAprMayJunJulAugSepOctNovDec12345678910111213141516171819202122232425262728293031,  19

Permanent Mailing Address:

School Address:

Home Telephone Number (include area code):

Daytime Telephone Number (include area code):

Family income range

Please list your financial need and list the amount and source of any other financial aid you have received:

Music Information

What is the genre of music you perform and want to pursue?

List your Musical Talents:

What is your primary instrument?

Who has had the biggest impact on helping you develop your interest in music?

Academic Information

List the Music Education institution or special master classes that this scholarship would be used towards:

Current Class Standing:
6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeCollege FreshmanCollege SophomoreCollege JuniorCollege SeniorCollege Post GradOther

Year in School to which Scholarship would apply:
7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeCollege FreshmanCollege SophomoreCollege JuniorCollege SeniorCollege Post GradOther

Current Cumulative Grade Point Average:

Activities: List any professional work experiences, extracurricular activities, and/or awards and honors

Postgraduate Plans:

List and attach two letters of reference (exclusive of relatives and fellow students) who are most familiar with your abilities and goals and/or experience in the field of music.

Reference #1 - Name, Address & Phone


Reference #2 - Name, Address & Phone

In essay tell us about your musical background, experience, your musical aspirations and your desire to continue your education in this field.

Paste your application essay into the text box below:

I have mailed a CD or DVD (up to ten minutes) of my talent and
     any other relevent material to the address below.
I have attached a digital file (up to ten minutes) of my talent.

I have listed a web address to access such file(s).

Certification:
I certify that the information provided on this application and all supplemental forms is complete and correct to the best of my knowledge. I further certify that if I am chosen as a scholarship recipient, I will use those funds only for expenses related to my education in an institution in the United States or with a master instructor, and I will provide a transcript or official notice of acomplishment at the end of the school year, academic semester or summer music program for which the scholarship will apply. If approved for a scholarship, you agree to provide a photograph of yourself for publicity purposes.

We reserve the right to verify any and all information provided in this application.
Applications must be in by July 31, 2008.

Your Initials:

Date: