SCHOLARSHIP FORM: FALL 2011 SESSION About Scholarships to The Art Center offers scholarship opportunities

students, adults and children, who demonstrate a nancial need and an interest in the arts. While other factors are taken into consideration, scholarships are strictly assigned on the basis of nancial need. Deadline The deadline for submitting an application is Sept. 6, 2011. Applications submitted beyond the deadline date will not be considered. If all application materials are not received on time the scholarship cannot be granted. Space in class may not be held while application is in process. Funds are limited and will be dispersed on a rst come, rst serve basis. Eligibility If you are already enrolled in a course, you may not submit a scholarship for any additional courses within the semester the scholarship is granted. Likewise you can not register for a class after accepting a scholarship within the same semester. You may not apply for scholarship more than two semesters with in a scal year. You can apply for scholarship for more than one child.
Applying for Scholarship* To be considered for a scholarship all elds of f the enclosed application must be completed and returned to the Art Center along with the following materials: a recent tax form or pay stub, a registration form, a personal letter and a letter of support. *Please Note: Applications will be returned and/ or postponed, if any of the above items are missing or incomplete.

Payment Procedures Scholarships cover tuition only. Recipients are responsible for any supplies or supply fees associated with class. If receiving a scholarship, any balance must be paid at the time of registration. Registration must be nalized within 5 days of notice, failure to do so will result in loss of scholarship and space in class will not be held. Registration Policies Scholarships (and scholarship applications) can not be transferable from one class to another (except in a situation where a selected class is cancelled by the Art Center and amount may be adjusted accordingly). Scholarships can not be transferable from semester to another semester.

Processing Procedures Scholarships will be collected until the deadline date, afterwhich all scholarships will be viewed collectively.

DEADLINE SEPT. 6, 2011

Mail To: Main Line Art Center Attn: Registrar 746 Panmure Road Haverford, PA 19041

Main Line Art Center

A. Applicant Information _____________________________________________________________________________________________

First Name Middle Initial Last Name Sufx D.O.B *If Under 18 years of age

Date of Application: ___________

*If Under 18 years of age _______________________________________________________________________

Parent/Guardian Name Relationship to Applicant

_____________________________________________________________________________________________ (_____)_______-________ (_____)_______-_______

Home Phone Work Phone Address Apt #

(_____)_______-________ ______________________
Cell Phone E-mail

City

State

Zip code

B. Financial Information of Applicant/Parent of Applicant

Status
(circle one)

SINGLE

MARRIED

SEPARATED

Number of Dependents (if applicable) ______ TOTAL HOUSEHOLD GROSS INCOME * _______ Below $15,000 (Please state amount) _______ $15,000 - $25,000 _______ $25,000 - $32,500 _______ $32,500 - $40,000 $40,000 or above (PLEASE STATE AMOUNT) $_________________________

C. Registration Fall 2011 ________________________________

________________________________ Class Title (ex. Creating Together) ________________________________ Day & Time (ex. Monday, 4:15 p.m.)
$________+ $______ = $__________ Tuition Fee Total

D. Check List

* Provide a copy of most recent tax statement or pay stub.

Applications will be delayed if incomplete. Submission of application indicates agreement to the registration and scholarship policies as outlined by Main Line Art Center. Include all of the following documents.

The following is not required, but your answers will assist us in serving you more effectively. 1. What is the highest level of Copy of most recent tax form or pay stub. education received in your household? Completed registration form for one selected class. (see C of this form) ________________________________ Personal letter explaining your decision to apply for scholarship. 2. Is there an adult in your household, that has been Letter of support from a clergy person, mentor or former teacher indicat- unemployed in the last year? Y N ing applicants commitment to the arts and the to time the class requires. 3. What is your race? __________________________________

E E.Optional Survey

MLAC USE ONLY Date Received: ___/____/_______ Date Approved: ___/____/_______ Date of Contact: ___/____/_______ Received By: Approved By: Contacted By: _______ _______ _______

Notes