Dear Parents,
Sur Les Pointes School of Ballet makes every effort to award financial aid when circumstances require it. We believe every child deserves the opportunity to enjoy the wide ranging physical and emotional health benefits dancing offers. SPSB staff reviews each application in confidence and makes award decisions based on the information you provide in this application.
Scholarship applications must be received no later than 3 weeks before the beginning of the session by email or fax. Please note that all scholarship applications require submission of the first page of the parents’ most recent 1040 US Tax Form, showing Adjusted Gross Income (AGI). Scholarship decisions cannot be made without the required tax information.
For any additional scholarship questions, please contact program director Linda Koon at: d.prise1990@yahoo.com
APPLICANT INFORMATION
Student Name {last name, first name}: ________________________
Home Address: ____________________________
City, State: _______________Zip: _______
Student Email: ________________________
Student Birthdate: ________________________
Parent(s) Name: ____________________
Parent Email: ______________________
Parent Home phone:__________________
Parent Cell phone: _________________
If student does not reside with both parents, please indicate with whom the student resides:
__________________________________________________
PROGRAM AND FINANCIAL REQUEST INFORMATION
Class Name(s): _________________________ Current Age: ____________
Listed program Fee: $_______
Expected family Contribution: $________
Total Amount Requested: $_________
PARENT SECTION TO COMPLETE - PLEASE ATTACH ADDITIONAL PAGES IF NEEDED What are the reasons for requesting these funds? Please note any extenuating financial circumstances (medical, job loss, unusual expenses, etc) or significant family expenses, including college or childcare costs.
ADDITIONAL REQUIRED INFORMATION (TO BE ATTACHED TO APPLICATION)
Parent IRS Form 1040 {Income Tax Return}
DISCLAIMER AND SIGNATURE
By signing below, we are stating that the information outlined above is accurate, and that the amount of scholarship funds we are requesting is necessary in order for the applicant to be able to attend this program. We realize that funds for financial assistance are very limited and that receiving the full amount of funds requested is not guaranteed. In order to receive scholarship awards, participants must successfully complete the program, which means participants must attend, and complete the program without any attendance problems. Should the participants fail to complete the session for any reason, the student and his/her siblings will be ineligible for future scholarship funds.
Parent Signature: ________________________________
Date: __________________________________________
FOR OFFICE USE ONLY
Date received: ___________
Received by: ___________________
Scholarship award: $ ___________________
Reviewed by: _____________________
Approved by: _______________________
