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, Guest!Wednesday, January 7, 2009A Non-Profit Organization




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Assistance Based Scholarship Application


Note: This application must be completed in full in order to be considered for a scholarship. All fields are required unless marked as "Optional". Information will remain confidential with the scholarship committee of the MTLC Board of Directors.


Student's Name:


Birthdate:
 /   / 


Parent's Name:


Address:

(Optional)

City, State, & Zip Code:
,


Home Phone:


Cell Phone: (Optional)


Email:




Single or Married?:


Occupation Of Mother:


Occupation Of Father:


Number Living In Household:
Adults: , Children:

Total Household Monthly Income:
$

What is the amount of tuition you will be able to pay per semester?:
$

Are you currently enrolled in a Music Time Learning Center class?:


Have you previously received a scholarship from Music Time Learning Center?:


Class You Are Applying For:


Briefly describe your need for financial assistance and what you hope Music Time Learning Center can provide for you and your child:



<< Check This Box To Accept The Following:
I understand that if I am awarded a scholarship I must attend at least 75% of the classes in order to be eligible for future scholarships. I also certify that the information entered in this form is complete and accurate to the best of my knowledge.







   

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