N Ferno Performing Arts Center Scholarship Application
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- Philomena Gallagher
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1 N Ferno Performing Arts Center Scholarship Application Ages 7 years and Older Season Application Deadline: Saturday, December 19,
2 PARENTS/GUARDIAN ONLY Submission Deadline: Saturday, December 19, 2016 Parent/Guardian Name: Applicant/Student/Child Name: Applicant s Availability to Start: Are there any Disabilities or Restrictions N Ferno should be made aware of? If yes, please list: Parent/Guardian s Date of Birth: Last Four Digits of Parent/Guardian s SS: Address: City: State: Zip: Parent/Guardian s Phone Number: Parent/Guardian s Address: Parent/Guardian s Signature: (By signing this document, you are indicating your intent to apply for a Scholarship Tuition Fund for your Child from N Ferno Performing Arts Center) Please READ this Entire Document CAREFULLY before signing. N Ferno Performing Arts Center is providing Full Scholarship s for Our 9 Month program. If your application is approved by N Ferno you will be responsible for the commitment of your child s participation until the conclusion of the 9 Month program. This program is designed to help Low Income Families. This program is separate from any other program offered at N Ferno and Grants/Scholarships CANNOT be combined or transferred at any time for any reason. Applicants/Students attendance & progress will be evaluated each month they are enrolled in the Scholarship Program by: ATTENDANCE: If a Student is absent more than twice a month (without a doctor s note, proof of immediate death in the family, or certain special circumstances) he/she may be released from their Scholarship and you will be financially responsible for the remaining of the Session here at N Ferno. Please initial to agree to these terms. COMMITMENT: Your child/dancer/applicant will be responsible for Commitment to N Ferno Performing Arts Center until the close of the Session ending with our Annual Recital in June If you do not commitment to the entire session, you will be financially responsible for any remaining months from the time of withdrawal/termination. Please initial to agree to these terms. Bank Name: Card Type: Visa MasterCard Discover Check Card # Exp.: / CVS Code: Or Zip Code: Checking Account: Routing No. 2
3 PROGRESSION: N Ferno is dedicated to Progression and Growth in Dance. Your child will be assessed during the duration of the Session on Progress, Growth, Flexibility, Technique, Knowledge, Precision, Execution, Preparedness for class, and Discipline. If we do not see improvement over a reasonable amount of time (Minimum of two months), N Ferno reserves the right to void the Scholarship and you will be financial responsible for the remaining months of the Session. Please initial to agree to these terms. FINANCIAL RESPONSIBILITY: If approved, N Ferno will cover all Monthly Tuition Fee s for the Entire Session (September June 2016). You will be responsible for a one time Costume fee of $60 per class (Due February 2016) any attire your dancer will need to participate during class, as well as any other fees (late pick up, etc.) from N Ferno. Please Initial to agree to these terms: PARENT/GUARDIAN CHECKLIST We evaluate each application on a financial need basis only. In order to be considered for N Ferno Scholarship fun you will need to provide the following: Household Size (How many persons are currently living in your household including yourself?) Two most recent pay stubs One Most recent utility Bill in YOUR name with YOUR current address Name of Your Workplace How Long have you worked here? Address: Telephone Number: N Ferno reserves the right to Approve or Deny this application during the evaluation process. Failure to provide ALL requested information can delay or possible deny your application. You are only allowed one application submission per Dance Session. If you are approved for a Dance Session Scholarship, you will have to re-apply each year as financial situations change. Please note: Your commitment and dedication is very important, if approved you are filling a spot that could have otherwise been given to another potential candidate. N Ferno is dedicated to making your child s dance experience productive, fun and a wonderful learning experience. Please take a moment to review this application in its entirety before submission. You will not be allowed to make changes to this application at any time after it has been submitted to N Ferno Performing Arts Center. By signing this document, you are agreeing to your intent to apply for a Scholarship Tuition Fund for your Child from N Ferno Performing Arts Center, provide factual and truthful financial information, as well as agreeing to ALL terms listed above. Print Name: Signature: Date: Applicant/Child Name: 3
4 Applicant/Student Name: Date of Birth: Age: Gender: Address: City: State: Zip: Applicant/Student Phone Number: Applicant/Student s Address: Applicant/Student s Signature: (If applicant is under 18 years of age, Parent/Guardian Please complete Bottom Portion) Parent/Guardian Name: Parent/Guardian Phone Number: Parent/Guardian s Address: Parent/Guardian s Signature: 4
5 Dance History Applicant/Student Name: What Classes are you currently enrolled in at N Ferno? Have you taken any additional intensives, workshops, and/or training outside of N Ferno? If yes, Please list: What is your favorite style of Dance and Why? How long have you been dancing? What are your strengths as a Dancer? What are your areas for improvement as a dancer? Are you currently enrolled in a School (Studio) or Dance Program? If Yes, Please list: Applicant/Student s Signature: (If applicant is under 18 years of age, Parent/Guardian Please complete Bottom Portion) Parent/Guardian Initial: 5
6 Mandatory Essay Please write a short essay on Why I love Dance? What does Dance Education Mean to Me? Why I should be a participant/student at N Ferno Performing Arts Center? Applicant/Student Name: Parent/Guardian Initial: 6
7 Letter of Recommendation Applicant/Student Name: Applicant/Student s Signature: (By signing this document, you are indicating your intent to apply for a Scholarship Tuition Fund from N Ferno Performing Arts Center) Thank you for your assistance in evaluating this applicant s talents & Character Name: Address: City: State: Zip: Phone Number: Address: Signature: By signing this document, you agree that all information and recommendation(s) provided is in fact true about the applicant. 1. How long have you know the applicant/student? 2. What is your relationship with the applicant/student? 3. What prompts you to recommend this person for a Scholarship from N Ferno? 7
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