Scholarship Application

Section 1: Student Information

First Name

School Attending

Last Name

Date of Birth

Section 2: Guardian Information

First & Last Name

Street Address

Phone

City

State

Zip

Section 3: Financial / Household Information

Household Monthly Income

(after taxes)

# of Dependants

Additional Monthly Income

Total Income

Total Household Size

(include everyone living in your house, regardless of relation)

Section 4: Questionnaire

Why do you believe the applicant deserves a scholarship?

What special traits or abilities does the applicant possess that would make them an asset to this program?

If you are not awarded a scholarship, but were allowed to use a payment plan, would you be able to afford tuition?

Yes

Section 5: Verification

I confirm that I have read the Matthews Playhouse Scholarship Application Terms and Conditions. To the best of my knowledge, the information I have supplied is correct. I agree to release and discharge Matthews Playhouse of the Performing Arts and it's officers, directors, and agents of and from any claims, demands, or liability of damage arising from the participation of my child in any classes and programs sponsored by Matthews Playhouse.

Your Signature

Today's Date