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2024 Scholarship Application
2024 Scholarship Application
Name
*
First
Last
Email
*
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Birth Date
*
Date Format: MM slash DD slash YYYY
Are you a previous scholarship winner?
*
Yes
No
In which instrument/category did you win previously?
Instrument
*
Please enter your instrument name, or voice.
Current school
*
Music director's name and contact info
*
Private instructor's name and contact info
*
Category
*
High School
Undergraduate
Graduate
Repertoire
*
Please list your competition repertoire. Include titles, composers, lengths and any other relevant information (opus #, key, etc.)
Photo ID
*
Please attach an electronic scan of your Georgia Drivers License or Georgia school ID.
Name of the camp or school you plan to attend
*
Please enter the name and location of the camp or school you plan to attend using scholarship award funds.
Method of payment (choose one)
*
$40 online donation via our website
$40 online payment via Zelle
$40 check via US postal mail
Click
here
for more information!
Consent to store application data
*
I am at least 18 years old and grant consent
The student must be at least 18 years old in order to grant consent. If they are under 18 years old, then a parent/guardian must complete this application. Checking this box attests that you are of adult age and hereby grant us permission to store this form's information on our web server. A copy of this information will be automatically transmitted via email to our Scholarship chair for evaluation. We will delete this form's information from our web server no later than May 1, 2022.
Competition rules agreement
*
I am at least 18 years old and fully agree
The student must be at least 18 years old in order to grant agreement. If they are under 18 years old, then a parent/guardian must complete this application. Checking this box attests that you are of adult age, and hereby attest that all information is correct, and agree that the student will abide by the rules of the competition and accept the judge's decision as final.
Applicant identification
*
I am the applicant who is at least 18 years old
I am a parent/guardian of an applicant under 18 years old
For student applicants under the age of 18 years old, the parent/guardian must complete this application. Please indicate above who is completing this application.
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If you have any questions please e-mail us at
Scholarships@AtlantaMusicClub.org
.
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