SCHOLARSHIP FORM: SUMMER 2012 (Adult Classes & Teen Studios

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About Scholarships
The Art Center offers scholarship opportunities to students, adults and children, who demonstrate a financial need and an interest in the arts. While other factors may be taken into consideration, scholarships are strictly assigned on the basis of financial need. Deadline The deadline for submitting an application is June 4, 2012. Late or incomplete applications will not be considered. Submitting an application does not guarantee a space in the class. Funds are limited and will be dispersed on a first come, first serve basis. Summer Camp scholarships require a separate application. Eligibility Applicants must become Members in order to be receive a scholarship. Adult students who are registered for more than one course during the same class session are not eligible for scholarships. However, families may apply for scholarships for more than one child within a class session. Each student is limited to 2 scholarships within a fiscal year (summer camp scholarships will be considered separately).
Applying for Scholarship* To be considered for a scholarship all fields of the below application must be completed and returned to the Art Center along with the following materials: a recent tax form or pay stub for each contributing adult, 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.

Scholarships cover tuition only. Recipients may be responsible for supplies or supply fees associated with the class. If receiving a scholarship, any balance must be paid at the time of registration. Registration must be finalized within 5 days of notice, failure to do so will result in loss of scholarship and space in the 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 DEADLINE JUNE 4, 2012
Payment Procedures

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 Suffix D.O.B *If Under 18 years of age Parent/Guardian Name Apt # Relationship to Applicant State

Date of Application: ___________

*If Under 18 years of age _______________________________________________________________________ _____________________________________________________________________________________________ (_____)_______-________ (_____)_______-_______
Home Phone Work Phone Address

(_____)_______-________ ______________________
Cell Phone

City

Zip code

B. Financial Information of Applicant (or Parent of Applicant)
Status
(circle one)

C. Registration

E-mail

SINGLE MARRIED

SEPARATED

Total number of people in the household ______ Number of dependents in the household ______ 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) $_________________________

Summer 2012

(Adult Classes & Teen Studios)
________________________________ Class Title (ex. Creating Together) ________________________________ Day & Time (ex. Monday, 1:30 pm)

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.

E.Optional Survey

 Copy of most recent tax form or pay stub for all contributing adults.  Completed registration form for one selected class. (see C of this form)  Personal letter explaining your decision to apply for scholarship.  Letter of support from a mentor or former teacher indicating your commitment to the arts and the to time the class requires.

The following is not required, but your answers will assist us in serving you more effectively. 1. What is the highest level of education received in your household? ________________________________ 2. Is there an adult in your household, that has been unemployed in the last year? Y N 3. What is your race? __________________________________

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

Notes

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