Download - Summer 2012 Scholarship Application Form
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8/2/2019 Summer 2012 Scholarship Application Form
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Main Line Art Center Date of Application: ___________A. Applicant Information
_____________________________________________________________________________________________First Name Middle Initial LastName Sufx D.O.B*If Under 18 years of age
*If Under 18 years of age _______________________________________________________________________ Parent/Guardian Name Relationship to Applicant_____________________________________________________________________________________________
Address Apt # City State Zip code
(_____)_______-________ (_____)_______-_______ (_____)_______-________ ______________________Home Phone Work Phone Cell Phone E-mail
B. Financial Information of Applicant (or Parent of Applicant)Status (circle one) SINGLEMARRIED SEPARATED
Totalnumberofpeopleinthehousehold______Numberofdependents in the household ______
TOTALHOUSEHOLDGROSSINCOME*_______Below$15,000 (Pleasestateamount)_______$15,000-$25,000_______$25,000-$32,500_______$32,500-$40,000_______$40,000orabove(PLEASESTATEAMOUNT)$_________________________*Provideacopyofmostrecenttaxstatementorpaystub.
C.Registration
________________________________
ClassTitle(ex.CreatingTogether)
________________________________
Day&Time(ex.Monday,1:30pm)
D.Check ListApplicationswillbedelayedifincomplete.Submissionofapplicationindicates
agreementtotheregistrationandscholarshippoliciesasoutlinedbyMainLineArtCenter. Includeallofthefollowingdocuments. Copyofmostrecenttaxformorpaystubforallcontributingadults. Completedregistrationformforoneselectedclass.(seeCofthisform) Personalletterexplainingyourdecisiontoapplyforscholarship.
Letter of support from a mentor or former teacher indicating your com-
mitmenttotheartsandthetotimetheclassrequires.
DateReceived:___/____/_______
DateApproved:___/____/_______
DateofContact:___/____/_______
ReceivedBy:
ApprovedBy:
ContactedBy:
Notes_______
_______
_______
MLAC USE ONLY
Summer 2012
(Adult Classes & Teen Studios)
DEADLINE SEPT. 6, 2011
About ScholarshipsTheArtCenteroffersscholarshipopportunitiestostudents,adultsandchildren,whodemonstrateanancialneedandaninterestinthearts.Whileotherfactorsmaybetakenintoconsideration,scholarshipsarestrictlyassignedonthebasisofnancialneed.
DeadlineThedeadlineforsubmittinganapplicationisJune4,2012.Lateorincompleteapplicationswillnotbeconsidered.Submittinganapplicationdoesnotguaranteeaspaceintheclass.Fundsarelimitedandwillbedispersedonarstcome,rstservebasis.SummerCampscholarshipsrequireaseparateapplication.
EligibilityApplicantsmustbecomeMembersinordertobereceiveascholarship.Adultstudentswho
are registered for more than one course duringthesameclasssessionarenoteligibleforscholarships.However,familiesmayapplyfor
scholarshipsformorethanonechildwithinaclasssession.Eachstudentislimitedto2scholarshipswithinascalyear(summercampscholarshipswillbeconsideredseparately).
Applying for Scholarship*TobeconsideredforascholarshipalleldsofthebelowapplicationmustbecompletedandreturnedtotheArtCenteralongwiththefollowing
materials:arecenttaxformorpaystubforeachcontributingadult,aregistrationform,apersonalletterandaletterofsupport.*Please Note:Applicationswillbereturnedand/orpostponed,ifanyoftheaboveitemsaremissingorincomplete.
Processing ProceduresScholarshipswillbecollecteduntilthedeadlinedate,afterwhichallscholarshipswillbeviewedcollectively.
Payment Procedures
Scholarshipscovertuitiononly.Recipientsmayberesponsibleforsuppliesorsupplyfeesassociatedwiththeclass.Ifreceivingascholarship,anybalancemustbepaidatthetimeofregistration.Registrationmustbenalizedwithin5daysofnotice,failuretodosowillresultinlossofscholarshipandspaceintheclasswillnotbeheld
Registration Policies
Scholarships (and scholarship applications) cannotbetransferablefromoneclasstoanother(exceptinasituationwhereaselectedclassiscancelledbytheArtCenterandamountmaybeadjustedaccordingly).Scholarshipscannotbetransferablefromsemestertoanothersemester.
SCHOLARSHIP FORM: SUMMER 2012 (Adult Classes & Teen Studios)
MailTo:Main Line Art Center
Attn:Registrar746PanmureRoadHaverford,PA19041
E.OptionalSurveyThe following is not required, but your answers will
assist us in serving you more effectively.1. What is the highest level of
education received in your household?
________________________________
2. Is there an adult in your household, that has been
unemployed in the last year? Y N
3. What is your race?
__________________________________
DEADLINE: JUNE 4, 2012