EmailMe Form - Musical Arts Institute Scholarship Application

Name

First Last

Parent/Guardian Name (If under 18)

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Home Phone

### - ### - ####

Work Phone

### - ### - ####

Cell Phone

### - ### - ####

Email

Please select which quarter you will be taking classes:

Will you be applying for a full scholarship?

Yes

No

Will you be applying for a partial scholarship?

Yes

No

EMERGENCY CONTACT INFORMATION

Contact Name

First Last

Contact Phone

### - ### - ####

Student Need Assessment

Does your family receive any type of financial assistance?

Yes

No

If yes, what type of assistance?

If yes, can you upload a verification document that ensures that you receive the assistance? For verification purposes only. All forms kept confidential

File Upload