CHRISTIAN SALCEDO MUSIC SCHOLARSHIP APPLICATION

INSTRUCTIONS: This form requires both student and parent/guardian responses. To apply for the Christian Salcedo Music Scholarship, please complete all form fields below. Applications are reviewed within 30 days of receipt. Questions can be emailed to info@lightupthequeen.org.

SECTION I: STUDENT INFORMATION (to be completed by the Student)

Your Name:

Address:

Phone:

Date of Birth:

School:

Grade:

Instrument(s) if any:

Have you studied music previously?

If yes, how long?

What class or classes is this scholarship being requested for?

SECTION II: STUDENT ESSAY (to be completed by the Student)

In 50 to 100 words, please let us know why you believe you are a fitting candidate for the Christian Salcedo Music Scholarship.

SECTION III: PARENT/GUARDIAN INFORMATION (to be completed by the parent/guardian):

Guardian Name(s):

Address:

Phone:

Email:

AGREEMENT: I understand that a scholarship award is contingent upon the student’s progress and full participation and cooperation in all classes, ensembles and other related activities. I further understand that the scholarship award is limited to up to $700 towards an appropriate musical instrument and/or related equipment, with the remainder of the $1400 applied to the cost for lessons at a verified musical instruction institution. I certify that the information provided on this form is correct and understand that false and/or incomplete information are grounds for forfeiting all scholarship awards.

Agreed and accepted by:

Parent/Guardian:

Date: