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Wednesday, January 7, 2009
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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:
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2 - Feb
3 - Mar
4 - Apr
5 - May
6 - Jun
7 - Jul
8 - Aug
9 - Sep
10 - Oct
11 - Nov
12 - Dec
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1991
Parent's Name:
Address:
(Optional)
City, State, & Zip Code:
,
Home Phone:
Cell Phone:
(Optional)
Email:
Single or Married?:
Single
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?:
Yes
No
Have you previously received a scholarship from Music Time Learning Center?:
Yes
No
Class You Are Applying For:
Village
Our Time
Imagine That
For The Young Child
Family Time
Music Box
Piano
ABC Music And Me (Special Needs)
Camps
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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