2018 Scholarship Application Cover and Check List

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1 2018 Scholarship Application Cover and Check List All completed applications must be received by Thursday, April 19. Be sure that your application packet includes all of the items listed in the check list below, in the order they are listed. Check List Completed Scholarship Application Form Personal essay (one page) Reference Contact Form and recommendation letter from a current teacher or industry professional (optional) Second Reference Contact Form and recommendation letter from a current teacher or industry professional Copy of a college acceptance letter (optional) Copy of any financial aid award letters received from college (optional) Copy of a second choice college acceptance letter (optional) Copy of any financial aid award letters received from second choice college Most recent high school transcript (copies are acceptable) 2018 Student Aid Report (SAR) ALL APPLICATION PACKETS MUST BE RECEIVED BY APRIL 19, Materials may be submitted through the following ways: By mail to Gordon Hay Scholarship Committee c/o Blumenthal Performing Arts Education Department 345 North College Street, Charlotte, NC By fax to By scanning and ing all materials to efigueroa@ncbpac.org By dropping off in person at the Guest Services desk at Sprit Square, 345 North College Street, Charlotte If you have questions regarding the application process, please call

2 2018 Scholarship Application Form Application and Information Release Statement The information provided in my application is, to the best of my knowledge, complete and accurate. I understand that false statements on this application will disqualify me from receiving a scholarship. Please submit typewritten responses. First Name Last Name Middle Initial Date of Birth Age Ethnicity Race Street Address City _State Zip Home Phone Cell Phone Address High School Weighted cumulative GPA _ Un-Weighted cumulative GPA List colleges or universities that have accepted you for fall 2018 enrollment: Desired degree and intended major Parent/Guardian Information Parent 1 Name Relationship Parent 1 Address (if different) Parent 1 Address _ Parent 2 Name Relationship Parent 2 Address (if different) Parent 2 Address _ Applicant s Name First Last

3 Briefly describe your non-performance training and experience to date in the performing arts (more detail may be included in your essay). List extracurricular activities in which you participated during your high school years- including community service. Please briefly state any leadership roles or responsibilities. Though meritorious in nature, financial need is also taken into consideration in determining Gordon Hay Scholarship recipients. Briefly describe how this unique award would enhance your educational experience. I verify that all information provided above is accurate. _ Applicant s signature Date

4 Write a one-page essay detailing why you should be selected for the Gordon Hay Scholarship. You may type in the space below or include a separate document (one page only) in your application packet.

5 2018 Reference Contact Form Applicant s Name First Name Last Name Applicant, please provide this form to the person(s) providing a letter of recommendation for you. To the Reference: The student named above is applying for the 2018 Gordon Hay Scholarship. The Gordon Hay Scholarship benefits a student within the Charlotte region who has demonstrated technical or artistic accomplishment in a non-performance area of the performing arts. The award is designated for special learning opportunities related to the recipient s career interest in a nonperforming area of the performing arts. Opportunities that the award may be used for include but are not limited to professional conferences, seminars, workshops, participation in an unpaid internship program, technology, books, supplies, and professional performances. Allocation of the award will be administered by the Education Department of Blumenthal Performing Arts. Please return this form and your one-page recommendation letter to the applicant so that he or she may submit it as part of a total application package. The Scholarship Committee will not review incomplete applications. The application deadline is April 19, Your Name Title School or Organization _ Relationship to the applicant _ How long you have known the applicant Address _ City State _ Zip Daytime Phone Address Signature _ Date _

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